Failure to Provide Consistent ADL Assistance Including Bathing, Nail, and Oral Care
Penalty
Summary
The facility failed to provide necessary assistance with activities of daily living (ADLs) for four residents who were dependent on staff for care. For one resident with cognitive impairment, staff did not consistently trim fingernails as scheduled, despite documentation indicating the task was completed. The resident's representative observed that the nails were long and untrimmed, and the resident also experienced gaps of up to ten days without being offered or provided scheduled bathing. The Director of Nursing Services (DNS) confirmed that the expected bathing schedule was not consistently followed for this resident. Another resident, who was cognitively intact but required moderate to maximal assistance with ADLs, reported inconsistent provision of scheduled showers. Review of records showed an 11-day period without bathing, and the DNS acknowledged that the resident was not consistently offered or provided bathing as scheduled. A third resident with right-side hemiplegia, who required assistance with oral care, was observed multiple times with visibly unclean teeth and reported that staff did not offer help with brushing teeth. Staff interviews confirmed that oral care was not consistently provided, despite care plans indicating the need for daily assistance. A fourth resident, also cognitively intact and requiring substantial assistance with bathing, reported not receiving a bed bath since admission. Documentation initially showed no record of bathing for a week after admission, and subsequent records confirmed a seven-day gap without bathing. Staff acknowledged that going a week without a shower was not acceptable, and no additional documentation was provided to show the care was given. These findings demonstrate a pattern of failure to provide essential ADL support, including nail care, bathing, and oral hygiene, as required by residents' care plans and facility policy.