Failure to Provide Personal Hygiene and Bathing Assistance to Dependent Residents
Penalty
Summary
Facility staff failed to provide necessary personal hygiene services to residents who were totally dependent on staff for activities of daily living (ADL). In one instance, a resident was observed to have long, yellowed, thickened, and misshapen toenails, with one toenail having fallen off. The resident’s Minimum Data Set (MDS) indicated total dependence on staff for personal hygiene. Interviews with staff revealed that toenail care was the responsibility of nurses or podiatry, but the resident had not been seen by podiatry until after the surveyor’s intervention, indicating a lack of timely care. Another resident, who was dependent for all ADLs due to diagnoses including muscular dystrophy and Friedreich ataxia, was reported by a family member to have not received a shower in years and to have a layer of filth on their head. Review of the resident’s medical record and facility documentation showed no evidence of showers or bed baths being provided over several months. The facility’s documentation systems, including Point of Care (POC) and paper shower sheets, lacked records of bathing or showering for this resident, except for two instances where refusal was documented. Staff interviews confirmed that showers were scheduled and assigned, but documentation was incomplete or missing. Both residents had care plans indicating total dependence on staff for personal hygiene and bathing, with goals for their ADL needs to be met. However, the lack of documented care and observations of poor hygiene demonstrated that the facility did not provide the required assistance with personal hygiene and bathing for these dependent residents.