F0550

D

Unauthorized Hair Cutting Without Consent for Cognitively Impaired Resident

Boston, Massachusetts Survey Completed on 01-21-2026

Penalty

No penalty information released

Summary

A resident with dementia and anxiety, admitted in December 2025, was severely cognitively impaired with a BIMS score of 4/15 and had an activated Health Care Proxy as of 12/05/25, meaning the resident could not provide consent for care decisions. The facility’s Patient Rights policy, approved 07/22/25, stated that all patients would be treated fairly with consideration of individual needs and that staff would respect each patient’s rights, individuality, dignity, and culture. Despite this, the resident’s Health Care Agent later reported that, sometime around Christmas while the resident was on the short‑term Recuperative Services Unit, approximately four inches of the resident’s hair had been cut without consent, resulting in an uneven appearance. The Health Care Agent stated that, due to the resident’s cultural background, cutting the resident’s hair was something to which the resident would not have consented.

During the facility’s review, a Personal Care Associate (PCA #1) reported that on 12/22/25, during the day shift, she had been assigned to provide care to this resident, who could not make his or her needs known. After showering and washing the resident’s hair, she observed significant tangles and knots. She attempted to brush and untangle the hair but was unable to remove all knots, and then used scissors to cut the knots from the resident’s hair. She did not inform the nurse on duty that she had cut the resident’s hair. The Risk Manager and DON both stated that cutting residents’ hair is not part of a PCA’s role, and the DON confirmed that PCA #1 had cut the resident’s hair on 12/22/25 without obtaining consent from the Health Care Agent, despite the resident’s inability to consent and the facility’s expectation that PCAs consult nursing staff when unsure about residents’ care needs or consent status.