Failure to Provide Needed Grooming and Personal Hygiene Assistance
Penalty
Summary
The facility failed to provide needed ADL care, specifically grooming and personal hygiene, to multiple residents who required assistance. One resident with bipolar disorder, anxiety disorder, major depressive disorder, and Parkinsonism was observed in the morning with a beard and mustache, stated he preferred to be clean shaven, and reported that CNAs did not have time to shave him. His MDS showed moderate cognitive impairment and a need for partial/moderate assistance with personal hygiene, and his care plan documented a self-care deficit requiring assistance with ADLs to maintain his highest level of functioning. Another resident with major depressive disorder was observed with hair on her chin and above her lip, stated she wanted to be shaved, and had an MDS indicating she was cognitively intact but needed setup or clean-up assistance with personal hygiene; her care plan also identified a self-care deficit and need for ADL assistance. A third resident with major depressive disorder, anxiety disorder, and Parkinsonism was observed with long fingernails on both hands and a black substance underneath. She stated she wanted her nails cut and that CNAs usually did this but had been too busy the last time she asked. Her MDS showed she was cognitively intact and required supervision or touching assistance with personal hygiene, and her care plan documented a self-care deficit and need for ADL assistance. A fourth resident with bipolar disorder, paranoid schizophrenia, and generalized anxiety disorder was observed with a beard, stated he wanted to be shaved, and reported that staff were too busy to shave him; his MDS showed he was cognitively intact and needed setup or clean-up assistance with personal hygiene, and his care plan also reflected a self-care deficit and need for ADL assistance. The DON stated that CNAs are responsible for ADLs such as shaving and nail care during showers and as needed, and the facility’s ADL policy emphasized maintaining personal hygiene, including shaving and self-manicure.
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