Failure to Provide Adequate ADL Assistance and Hygiene
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. Observations and interviews revealed that one resident was found wearing a soiled and stained top, another had soiled pants and unwanted facial hair, and a third had crumbs on her blanket, unwanted facial hair, and a brown substance under her fingernails. These findings were corroborated by direct observation and interviews with staff, who confirmed their responsibility for ensuring residents were clean and well-groomed. Record reviews indicated that all three residents had significant cognitive impairments and required extensive or maximal assistance with ADLs, including personal hygiene, dressing, and grooming. Care plans for each resident documented their dependence on staff for these tasks and outlined interventions to address their deficits. Despite these documented needs and interventions, the residents were observed in unclean and unkempt conditions during the survey. Interviews with CNAs, the DON, and the administrator confirmed that staff had received training on ADL care and were aware of facility policies requiring regular checks and assistance with hygiene and grooming. Staff acknowledged the importance of maintaining residents' cleanliness and dignity but were unable to explain why the affected residents were left in dirty clothing and with unmet hygiene needs. The facility's policy stated that residents unable to perform ADLs should receive necessary services to maintain good nutrition, grooming, and personal hygiene.