Failure to Assist Resident With Grooming, Shaving, and Clean Clothing
Penalty
Summary
The deficiency involves the facility’s failure to provide adequate assistance with activities of daily living (ADLs), specifically grooming, shaving, and maintaining clean clothing for Resident 25. The resident’s EMR documented Alzheimer’s disease, major depressive disorder, hypertension, lack of coordination, and a need for assistance with personal care. A recent MDS showed moderately impaired cognition with a BIMS score of 12 and documented that the resident required setup or cleanup assistance with eating, supervision or touch assistance with oral hygiene, partial/moderate assistance with toileting, and substantial/maximal assistance for bathing. The Care Area Assessment indicated the resident triggered for further review of functional abilities due to cognitive status and increased ADL assistance needs, and the care plan documented dependence on staff for bathing, moderate assistance for personal hygiene and dressing, and a preference to be shaved daily. Despite these identified needs and care plan directives, observations showed the resident sitting in a recliner with greasy hair, three-to-four days of facial hair growth, and a blue shirt with two large food stains that the resident reported were from the previous evening’s supper and had not been changed. The resident stated he liked his face shaved every day and could not remember his last bath. Bathing records showed only sporadic baths and one documented refusal, and staff interviews confirmed that while residents were asked about baths and refusals were reported to nurses, CNAs were expected to change clothing and provide hygiene when residents appeared unclean. Administrative staff stated the expectation that residents receive at least one shower weekly and that CNAs wash and change residents’ clothes and shave them as desired, but the observed condition of the resident and the resident’s statements demonstrated that these expectations were not met, resulting in a failure to ensure assistance with grooming, shaving, and clean clothing in accordance with the resident’s needs and preferences.
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