Failure to Provide Consistent ADL Care and Personal Hygiene
Penalty
Summary
The facility failed to provide necessary assistance with activities of daily living (ADLs) for two residents who were unable to perform these tasks independently. One resident, a male with Alzheimer's Disease, dementia, muscle weakness, and impaired mobility, was dependent on staff for all ADLs. Despite a care plan goal for the resident to be well-groomed and clean, observations revealed greasy hair, dirty sheets, and the resident reported not receiving showers or baths three times a week as required. Review of shower sheets confirmed that the resident missed 13 scheduled baths over a two-month period, with only a few bed baths documented and some refusals noted. Staff interviews indicated a lack of clarity regarding shower schedules and issues with linen delivery, but no prior awareness of missed showers. Another resident, with diagnoses including chronic metabolic acidosis, muscle wasting, and a chronic skin ulcer, required supervision or assistance for personal hygiene and bathing. Observation showed this resident had long, yellow fingernails with a dark substance underneath, and the resident reported waiting for a bath and nail care. Documentation revealed missed or unverified showers and nail care, with staff acknowledging the resident could be difficult to bathe or provide nail care for, but also indicating that ADL care should have been provided prior to the resident leaving for a medical appointment if not refused. Record reviews and staff interviews confirmed that the facility's policy required providing necessary care for residents unable to perform ADLs to maintain proper grooming and hygiene. However, the facility did not ensure consistent delivery of showers, baths, and nail care for these dependent residents, as evidenced by missed care opportunities and incomplete documentation.