Failure to Provide Required ADL Assistance to Dependent Residents
Penalty
Summary
The facility failed to provide necessary assistance with activities of daily living (ADLs) to residents who were dependent on staff for personal hygiene, grooming, and bathing. According to the facility's policy, residents unable to perform their own ADLs should receive services such as bathing, dressing, grooming, oral care, and fingernail care based on their comprehensive assessment and care plan. However, observations, interviews, and record reviews revealed that multiple residents did not receive the required assistance, despite being assessed as needing it and not refusing care. For example, one resident with respiratory issues required staff help for toileting, transferring, personal hygiene, and bathing, but was repeatedly observed with long, dirty fingernails and unshaven. The resident reported that staff did not assist with shaving or nail care, and staff interviews confirmed that care was not provided as expected. Another resident with lower body impairment after a stroke was dependent on staff for personal hygiene and bathing, yet was observed multiple times with long, dirty fingernails and stated that staff did not help with nail care. Staff acknowledged that care, including nail clipping and hygiene, was not consistently provided. Additional residents with anxiety, respiratory, and vision issues were also observed with poor hygiene, including long, dirty fingernails, greasy hair, and unshaven appearance. These residents required moderate to total assistance with ADLs and did not refuse care, but staff interviews and observations confirmed that morning care, showers, and nail care were not provided as scheduled or as needed. The facility's failure to follow its own policies and care plans resulted in residents not receiving the necessary assistance with ADLs.