Failure to Provide Assistance with ADLs Including Hair, Nail, and Oral Care
Penalty
Summary
The facility failed to provide adequate assistance with activities of daily living (ADLs), specifically hair, nail, and oral care, for three residents who required such support. Observations and interviews revealed that these residents had unwashed, oily, and uncombed hair, as well as visible dirt under their fingernails. One resident also reported not having their teeth brushed since admission, despite oral care supplies being available in their room. These deficiencies were noted during multiple observations by surveyors and confirmed by nursing staff. The affected residents had significant medical conditions, including morbid obesity, diabetes with foot ulcers, and chronic respiratory failure, all of which contributed to their need for assistance with personal care. Care plans for each resident documented self-care deficits and interventions requiring staff to assist with ADLs as needed. Despite this, documentation and direct observation indicated that staff did not consistently provide the necessary grooming and hygiene care, even though alternative supplies such as bathing wipes and shampoo caps were available during a facility water emergency. Interviews with staff and review of facility policies confirmed that supplies for waterless hair washing and oral care were accessible and stocked. However, staff failed to utilize these resources to maintain residents' hygiene. The facility's policy required that residents unable to perform ADLs independently receive appropriate care to maintain grooming and personal hygiene, but this standard was not met for the residents reviewed.