F0677

D

Failure to Provide Required Grooming and Feeding Assistance for Dependent Residents

Toledo, Ohio Survey Completed on 02-24-2026

Penalty

No penalty information released

Summary

The deficiency involves the facility’s failure to provide necessary ADL assistance with grooming and feeding to residents who were dependent on staff. One resident with multiple diagnoses including COPD, cardiac arrhythmia, generalized muscle weakness, osteoarthritis, OSA, CHF, lymphedema, RA, atherosclerotic heart disease, HTN, morbid obesity, major depressive disorder, and anxiety had a quarterly MDS showing relatively intact cognition (BIMS 13) but unilateral upper extremity impairment and dependence or need for maximal assistance with all functional abilities, including hygiene. During observation, this resident was noted to have multiple long, coarse hairs on her chin and upper lip. In a concurrent interview, she stated the facility did not assist her with grooming her facial hair as much as she liked and that it bothered her when the hair was long enough to be visible. A CNA later verified the presence of the long, coarse facial hair.

Another resident, admitted with diagnoses including Type II diabetes mellitus, hypothyroidism, hypokalemia, adult failure to thrive, and anxiety disorder, had a quarterly MDS indicating impaired cognition (BIMS 8) and a need for assistance with meals and dependence on staff for ADL care. The care plan documented an ADL self-care performance deficit related to impaired vision and arthritis, with interventions for staff to assist with eating, encourage self-feeding if possible, and use a clock system to describe plate setup because the resident was blind. The care plan also identified risk for nutrition and hydration deficits related to multiple conditions and diuretic use, with interventions including providing ordered supplements and monitoring intake and weight. The facility’s assisted dining list also identified this resident as requiring assistance with eating.

During a lunch observation period, this blind resident was in bed on her right side with the head of the bed elevated, while her meal tray was placed on the left side of the bed, out of her line of sight, and an additional tray with milk, a nutritional supplement, and a fruit cup was left on a chair near the door. No staff entered the room to assist her with eating during the observation. The resident reported she was not aware her lunch was on the bedside table and that no staff had been in to assist her. A CNA confirmed the resident had not been assisted to eat and acknowledged she had not been in the room and did not know who had set up the tray. A housekeeper reported moving the tray from the chair to the bedside table after noticing it, and stated she did not see staff assisting the resident and tried to help when she could. A dietary technician confirmed the resident should be assisted at meals and offered the facility meal, with an alternative if refused. These events occurred despite facility policies stating that residents unable to carry out ADLs would receive necessary services for grooming and that staff would supervise and assist with meals, including arranging trays so residents could reach items and opening containers.