F0600

J

Resident’s Hair Cut and Shaved Against Expressed Refusal, Constituting Abuse

Sinking Spring, Pennsylvania Survey Completed on 01-08-2026

Penalty

No penalty information released

Summary

The facility failed to protect a resident from physical and mental abuse when staff cut and shaved the resident’s hair against her expressed wishes. Facility policies on Abuse Prohibition and Treatment: Considerate and Respectful required that residents be free from abuse, mistreatment, and neglect, and that grooming respect resident preferences for hairstyle and length. The resident had chronic pain syndrome, major depressive disorder, and anxiety, and her MDS showed she was alert, oriented, reported feeling down or hopeless several days per week, and was dependent on staff for personal hygiene. Her care plan documented that she often refused care due to personal preference and that staff were to postpone activities if she refused.

On the date of the incident, the resident reported that staff told her not to talk to anyone about certain things and that staff shaved her head using an electric razor after she said no. She stated she previously had a ponytail and that staff shaved her hair like she was a prisoner, without trying any other options. She reported that after staff shaved her head, they took her to the shower. Observation showed her hair was visibly short and uneven, with varying lengths from close to the scalp to about a half inch, and she was seen rubbing her hand over her hair and moving her head during the interview.

Staff interviews confirmed that the DON instructed staff to cut the resident’s hair and that scissors and an electric razor were used. The DON acknowledged that the resident “freaked out,” said she did not want her ponytail cut, and objected to the hair being cut, and that no other options were discussed or attempted. A nurse aide stated that the resident screamed no until after her hair was cut, then became silent. The resident’s roommate reported that after staff cut the resident’s hair, the resident was in the room crying. There was no documentation that the resident had tangled hair, a medical need, or any other condition requiring her hair to be cut, no evidence that alternatives such as consultation with a hairdresser or a scheduled haircut were offered, and no documentation that staff acknowledged or honored the resident’s refusal.

Removal Plan

• Resident 1 was seen by social services, psychiatry, and the physician.
• The facility will conduct a full abuse investigation.
• The facility will report the allegation to the Department of Health, Pennsylvania Department of Aging, the local Police Department, and the Area Agency on Aging.
• Psychiatry/psychology services will continue to follow Resident 1 routinely.
• All residents will be assessed for injuries or trauma, with follow-up if needed. If any allegations are brought forward, they will be reported to the abuse coordinator, the resident will be removed from the situation, and staff will be placed on leave if identified as the perpetrator.
• The Administrator will re-review the abuse policy.
• The facility will educate all staff on abuse protocols, resident rights, and refusal of care. Staff members will be given a quiz with the education.
• The facility suspended all involved staff members.
• Weekly audits and then monthly audits will be conducted of any potential abuse allegations and the results discussed at the QAPI committee.