Failure to Provide Scheduled Showers and Nail Care per Care Plan
Penalty
Summary
Two residents did not receive necessary assistance with activities of daily living (ADLs) as required by their care plans and facility policy. One resident, with a history of a rare neuromuscular disorder, bladder dysfunction, pain, cellulitis, and urinary retention, was dependent on staff for bathing and had a physician order for weekly showers. On the scheduled shower day, the assigned shower aide was absent due to illness, and the resident was not provided with a shower or an alternative bathing method. The resident was not informed about the missed shower and expressed concern, noting that a shower had also been missed the previous week. Documentation confirmed that the last shower provided was nearly two weeks prior, despite the resident's dependence on staff and stated preference for showers. Another resident, diagnosed with diabetes mellitus with neuropathy and requiring assistance with personal care, did not receive regular nail care as outlined in the care plan and facility policy. The care plan specified referral to podiatry for nail trimming, but the resident's toenails were observed to be long, and the resident expressed a preference for short nails. Staff interviews revealed that the resident was not on the current podiatry list, and there was a lack of communication regarding the need for podiatry services. The facility required consent from the resident's power of attorney for podiatry visits, which had not been obtained in a timely manner, resulting in the resident not receiving necessary nail care. The facility's policy stated that all residents should receive weekly showers or baths and regular nail care as needed. However, both residents did not receive these services according to their care plans and preferences. Staff interviews and documentation review confirmed that the facility failed to provide the required ADL care, and no additional information was provided to explain the lack of services.