Failure to Provide Adequate ADL Assistance and Grooming
Penalty
Summary
The facility failed to provide adequate care and assistance with activities of daily living (ADLs) for three residents who required support with grooming, nail care, and personal hygiene, as outlined in their care plans. For one resident with a history of stroke, muscle weakness, chronic kidney disease, and diabetes, observations revealed unshaven facial hair and long, unclean fingernails with debris, despite the resident expressing a desire to be shaved and no documented refusals of care. Staff interviews confirmed that nail care was expected to be provided during showers or by nurses for diabetic residents, but records showed no refusals or documentation of care being provided. Another resident, also with a history of stroke and joint replacement, was observed lying in bed with a stained shirt, unshaven facial hair, and long, dirty fingernails. The resident expressed frustration about not receiving enough assistance. Task records indicated scheduled showers, but there was no documentation of showers being given or refused on several dates, suggesting a lack of care provision and documentation. A third resident, dependent on staff for all ADLs due to severe cognitive impairment, was repeatedly observed with uncombed hair, long and dirty fingernails, and wearing the same nightgown for days. Family members reported concerns about the resident's appearance and lack of mobility. Staff interviews indicated that nail care and grooming were expected but not consistently documented or performed, and there was no evidence of care refusals. Multiple observations confirmed ongoing unmet grooming and hygiene needs for this resident.