Failure to Provide Required ADL Assistance for Dependent Resident
Penalty
Summary
A deficiency was identified when a resident with multiple sclerosis and spastic paraplegia, who was assessed as being dependent on staff for all activities of daily living (ADLs) including oral hygiene, grooming, and shaving, did not receive the necessary assistance for these tasks. The resident's care plan specified total assistance with grooming, oral care twice daily, and shaving every other day. Despite these documented needs and facility policy requiring daily personal hygiene and twice-daily oral care, observations and interviews revealed that these services were not provided as required. Surveyor observations over two consecutive days showed that the resident was not offered or provided with oral care, shaving, or hair brushing/combing during morning care routines. The resident was repeatedly observed with unshaven facial hair and disheveled hair, and confirmed that oral care was not performed before breakfast. Staff interviews further indicated a lack of awareness or adherence to the care plan, with a CNA stating that oral care was performed only every other day and expressing uncertainty about the availability of oral swabs for residents unable to use a toothbrush. The CNA also reported that shaving and hair brushing were typically performed by the resident's wife rather than facility staff. The facility's own policy and the resident's care plan both required staff to provide and document daily personal hygiene and oral care, as well as regular shaving and grooming. However, direct observations and staff interviews confirmed that these essential care activities were not consistently performed or offered, resulting in the resident not receiving the necessary services to maintain good grooming and hygiene as required.