Failure to Provide Dignified Grooming and Shaving as Requested
Penalty
Summary
Surveyors identified a deficiency in the facility’s failure to provide dignified grooming and personal hygiene assistance as care-planned and requested for one resident. The resident’s quarterly MDS documented multiple diagnoses including coronary artery disease, diabetes mellitus, anxiety disorder, depression, a left hip fracture, and generalized muscle weakness, and indicated the resident required substantial or maximal assistance with personal hygiene. The resident’s care plan, last revised on 02/13/2026, specified that she preferred her hair to remain long and brushed daily and that she requested to be shaved daily, with this shaving preference initiated in the care plan on 02/22/2025. Despite this, direct observation on 02/10/2026 at 11:36 AM showed the resident with a long, substantial beard and matted, unwashed hair. During interviews, the resident reported she requested staff to help her shave whenever they offered a shower, preferred bed baths, and was told by staff they could not shave her because she was diabetic and that only a barber or nurse could shave her due to her diabetic status. She stated this lack of assistance increased her feelings of depression. Review of the Kardex for personal hygiene and bathing from 01/13/2026 to 02/11/2026 showed no documented refusals for showers, personal cares, or bathing, and indicated bathing was documented as occurring every day with extensive assistance provided on more than half of the opportunities. A facility barber reported hearing from other residents that staff refused to trim or cut facial hair and believed CNAs and shower aides could cut hair but that this was not regularly done due to staffing shortages. An RN confirmed the resident had been asking to have her facial hair removed for several days and was unsure if CNAs could shave a resident with diabetes. A CNA familiar with the resident confirmed the resident preferred to be clean shaven and that refusals would be documented in the EHR. The ADON confirmed shaving is provided for residents who request it and that staff are expected to provide this service, and facility policy on shaving required refusals to be reported to a nurse supervisor and documented in the medical record.
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