Failure to Provide ADL Assistance and Honor Resident Preferences for Hygiene
Penalty
Summary
The facility failed to provide necessary assistance with activities of daily living (ADLs), including showers, oral care, and grooming, to residents who were dependent on staff for these tasks. For one resident with hemiplegia and hemiparesis, documentation showed that oral care was not provided twice daily as required by facility policy on multiple occasions, and no showers or bed baths were documented on several scheduled days over a 30-day period. There was no documentation of refusals for showers or bed baths, despite the resident's care plan indicating a history of refusal for oral and hair care. Another resident, who required assistance from one to two staff for bathing and a mechanical lift, expressed dissatisfaction with only receiving bed or sponge baths instead of showers, which was her stated preference. Documentation revealed significant gaps in bathing and showering, with extended periods where no hygiene care was recorded. Observations confirmed the resident's hair was uncombed and facial hair was not removed, despite her preference for grooming. Staff interviews revealed that the resident could not access the shower room due to physical limitations and equipment constraints, and her preferences were not honored. A third resident, who was blind and required extensive assistance for ADLs, did not receive scheduled showers or baths on several occasions within a 30-day period. The resident reported not receiving showers or baths as scheduled, and records confirmed that only four out of nine scheduled hygiene sessions were provided. The administrator acknowledged that the frequency of showers and baths was insufficient for this resident.