Failure to Provide Grooming Assistance for Facial Hair Removal
Penalty
Summary
Surveyors identified a deficiency in the facility’s provision of assistance with activities of daily living (ADLs), specifically grooming and personal hygiene, for one resident. The resident was an older female with non-Alzheimer’s dementia and hypertension whose Quarterly MDS showed a BIMS score of 13, indicating intact cognition, and a need for partial/moderate assistance with showering/bathing. Her care plan, revised 12/10/25, documented that she required assistance with ADLs related to visual impairment, weakness, and impaired cognition, with a goal to remain clean, dry, odor-free, and well-groomed, and an approach indicating extensive to total one-person assistance with bathing. On observation, the resident was seen sitting at the edge of her bed with scattered chin hair approximately 3/4 inch long. She reported receiving regular showers on a Monday-Wednesday-Friday schedule and stated she had been asking staff to shave her chin hair, but was told that, per facility policy, there were no razors in the facility. She reported feeling embarrassed, avoiding leaving her room, eating in her room, and not going to the dining room because of her facial hair. Interviews with staff confirmed that CNAs were responsible for showers and grooming, including facial hair removal for female residents, and that the facility did have disposable razors for resident use. LVN B stated that CNAs should inspect and trim or shave female residents’ facial hair weekly on shower days according to resident preference, and that charge nurses were responsible for ensuring residents received appropriate and consistent daily care. CNA A stated CNAs were responsible for shaving/removing facial hair on shower days and as needed, and acknowledged the facility had disposable razors, adding that he did not know who told the resident that the facility did not have razors. The DON stated CNAs were supposed to shave/remove female residents’ facial hair on shower days or as desired by the resident, confirmed that razors were part of residents’ grooming supplies, and stated she had not been notified that this resident had facial hair and wanted to be shaved. The facility’s “Activities of Daily Living, Optimal Function” policy stated the facility provides necessary care to residents unable to carry out ADLs to ensure they maintain proper grooming and hygiene. Despite this policy and the resident’s care plan, the resident’s request for facial hair removal was not carried out, resulting in unaddressed grooming needs on the date of observation.
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