Failure to Provide Timely ADL Assistance for Residents Needing Personal Hygiene Support
Penalty
Summary
Surveyors observed that the facility failed to provide necessary assistance with activities of daily living (ADLs) for four residents who required help with personal hygiene tasks such as nail care and shaving. Direct observations revealed that one resident had long fingernails with a black substance underneath, despite requesting assistance from CNAs, while another had long yellow fingernails and also expressed a desire for nail care. Two additional residents were noted to have facial hair and stated they wanted to be shaved, but reported that CNAs had been too busy to assist them. These residents had documented diagnoses including major depressive disorder, dementia, anxiety disorders, schizophrenia, and impaired mobility, and their care plans indicated a need for substantial or maximal assistance with personal hygiene. Interviews with the residents confirmed that their requests for assistance with ADLs had not been fulfilled. The Director of Nursing stated that ADL care, including shaving and nail care, is typically provided on shower days or as needed, according to resident preference, and that CNAs are responsible for these tasks. Facility policy requires evaluation and provision of care to meet each resident's physical and psychosocial needs, including ADLs. Despite these policies, the observed lack of assistance resulted in unmet hygiene needs for the affected residents.