Failure to Provide Adequate Oral and Nail Care for Dependent Residents
Penalty
Summary
The facility failed to provide necessary assistance with activities of daily living (ADLs) for three residents who were unable to perform these tasks independently. Specifically, one resident with quadriplegia and multiple complex medical conditions, including dysphagia and cerebral palsy, was not provided with adequate oral care. Observations over several days revealed the resident had bad breath, dry lips, and a thick white film on his teeth. The resident reported that his teeth had not been brushed in a month and denied refusing oral care. Staff interviews confirmed that the resident required total assistance and that oral care was the responsibility of the CNAs assigned to his hall. Two other residents, both with intact cognition and requiring assistance with personal hygiene, were not provided with adequate nail care. Observations showed that their fingernails were more than half an inch past the fingertips, jagged, and had dark debris underneath. Both residents expressed dissatisfaction with the condition of their nails and stated they wanted them trimmed. Despite care plans indicating that nail care should be performed on bath days and as needed, there was no evidence that nail care was provided during the survey period. Staff interviews confirmed that CNAs were responsible for providing nail care, except for diabetic residents, and that nail care was typically performed on shower days. The facility's policy required that residents unable to perform ADLs independently receive necessary services to maintain good nutrition, grooming, and personal and oral hygiene. However, the observed lack of oral and nail care for these residents demonstrated a failure to follow care plans and facility policy.