Failure to Provide Assistance with Personal Hygiene and Grooming
Penalty
Summary
The facility failed to provide necessary assistance with activities of daily living (ADLs), specifically personal hygiene, bed baths, showers, nail care, and grooming, to multiple residents who were identified as needing such support. Observations and interviews revealed that several residents with significant physical and cognitive impairments, including those with cerebrovascular disease, hemiplegia, morbid obesity, Parkinson's disease, Huntington's disease, and intellectual disabilities, were left with untrimmed, dirty fingernails, unshaven or overgrown facial hair, and soiled clothing or bedding. These residents were documented as requiring moderate to maximum assistance with ADLs in their care plans and Minimum Data Set (MDS) assessments. Surveyors observed residents with visible hygiene deficits, such as food crumbs on clothing, brown and black substances under fingernails, and accumulation of dead skin and bodily fluids on bedding. Multiple residents expressed a desire for assistance with nail care and shaving, stating that their requests had not been addressed by staff. In several cases, staff and the Director of Nursing acknowledged that the residents required assistance and that the observed hygiene issues were present, confirming that care had not been provided as outlined in the residents' care plans. The lack of assistance was consistent across several days and was observed in both cognitively intact and impaired residents. Documentation and staff interviews confirmed that the facility's standard practice includes providing showers or bed baths, nail care, and grooming at least twice a week and as needed, but these services were not consistently delivered to residents who were dependent on staff for their personal hygiene and grooming needs.