Failure to Provide ADL Care and Appropriate Attire for Resident
Penalty
Summary
The facility failed to follow its Activities of Daily Living (ADL) policy by not providing necessary care such as bathing, dressing, and grooming for a resident with multiple medical diagnoses, including cerebral ischemia, hypertension, type II diabetes, arthritis, constipation, and unspecified psychosis. The resident was observed sitting on the bed with an open hoodie, no shirt, stained pants, one sock, untied shoes, and a strong foul odor. The resident reported only having one sock and no other clothes, and stated that showers had not been offered for a long time. Staff interviews confirmed the resident had limited clothing and often refused showers and changes of clothes, but also revealed that no attempts were made to provide clean donated clothing that morning due to the expectation of refusal. The resident's care plan did not document any non-compliance with care or adverse behaviors, despite staff stating a history of refusals. On the day of a medical appointment, the resident was sent out inappropriately dressed, without a coat, and unbathed, which was noted by the physician's office. The nurse was not informed that the resident had refused to shower or change clothes before the appointment, and the director of nursing was notified only after the hospital called about the resident's attire. The facility's ADL policy requires recognition and evaluation of inability or risk for decline in ADL performance, and the resident rights policy emphasizes respect and dignity, both of which were not upheld in this instance.