Failure to Provide Assistance with Activities of Daily Living
Penalty
Summary
The facility failed to provide necessary assistance with activities of daily living (ADLs) for residents who required help, as evidenced by observations and interviews with two residents. One resident was observed waiting in her wheelchair in the hallway, crying and expressing an urgent need to use the bathroom, but was unable to do so because her roommate was occupying the shared bathroom. Despite activating her call light and requesting help, she waited a long time without assistance and ultimately feared she would be incontinent. Later, the same resident was noted to have greasy, uncombed hair and facial hair, and reported that staff had not combed her hair or brushed her teeth that morning. Her care plan indicated she required staff assistance for personal hygiene and toileting due to impaired mobility, vision, and a history of stroke, but these needs were not met as observed. Another resident was seen in the dining room with greasy, uncombed hair and noticeable facial hair, and reported that despite repeated requests for help with facial hair removal, staff had not provided the assistance. This resident's care plan also required staff to assist with ADLs, including personal hygiene and bathing, due to impaired mobility and other medical conditions. There was no documentation of care refusals or combative behavior in her record. The Director of Nursing confirmed that CNAs are expected to provide such care but acknowledged the facility lacked a formal policy on ADL provision.