Failure to Provide Resident with Requested Grooming and Hygiene Assistance
Penalty
Summary
A deficiency was identified when a resident with chronic pain syndrome, major depressive disorder, and anxiety disorder, who was cognitively intact and required staff assistance with personal hygiene, was not provided with adequate grooming and hygiene care. The resident's care plan specified the need for limited assistance with activities of daily living, including personal hygiene, and directed staff to document refusals and reapproach as needed. Despite these directives, there was no documentation that the resident received scheduled bed baths, shaving, or hair washing over a one-month period, nor was there evidence of refusals for these services. Observations and interviews revealed that the resident repeatedly requested assistance with shaving and hair washing, expressing frustration and stating that the lack of care made them feel dirty and grubby. Staff interviews confirmed that due to staffing challenges, they were sometimes unable to provide scheduled showers, bed baths, or grooming assistance. The resident reported asking multiple staff members, including a supervisor, for help with shaving and a shampoo cap, but did not receive the requested assistance. Progress notes and the bath list lacked documentation of these services being offered or refused. Further interviews with nursing management and facility administration indicated that staff were expected to offer and document personal hygiene care, and to reapproach residents if care was initially refused. However, the administrator and DON were unaware that the resident was not receiving assistance with shaving and hair washing. The resident continued to report feeling unclean and dissatisfied with their care, and the medical director acknowledged the potential for psychosocial harm resulting from the lack of person-centered care.