Failure to Provide Required Hair Care and Scheduled Hygiene Services
Penalty
Summary
A deficiency occurred when a resident who was dependent on staff for activities of daily living (ADLs), including personal hygiene and grooming, did not receive necessary hair care and scheduled showers or baths. The resident, who had multiple diagnoses such as cognitive communication deficit, muscle wasting, Parkinson's disease, diabetes, dementia, and major depressive disorder, was assessed as requiring assistance with personal care and was dependent for showers and partial/moderate assistance with hair care. Despite these needs, documentation showed missed or incomplete records for scheduled showers and personal hygiene, with several days lacking any documentation or indication of care provided. There was also no documentation specific to hair care, and no refusals were noted in the records for the relevant period. The resident developed a large mat of hair at the back of her head, which had to be cut out. Family concerns were raised when a family member discovered the hair mat during a visit and noted that she had not been notified of any refusals for showers. Staff interviews revealed that the resident often refused showers and hair care, preferring bed baths, but when bed baths were provided, hair care was not performed. Staff also admitted to sometimes missing documentation of refusals and not always informing the charge nurse as required. The care plan did not include specific interventions for hair care refusals, and there was a lack of consistent documentation and communication regarding the resident's refusals and the care provided. Interviews with nursing and administrative staff confirmed that the expectation was for residents to receive scheduled showers and hair care, and that refusals should be documented and reported. However, staff were not consistently aware of the resident's refusals or the lack of hair care, and notifications to family members were not made until after the issue was identified. The facility's own policy required documentation of care provided, refusals, and notification of supervisors, but these procedures were not followed, resulting in the resident not receiving necessary grooming and hygiene services.