Failure to Provide Needed ADL Assistance With Facial Grooming
Penalty
Summary
The deficiency involves the facility’s failure to provide necessary assistance with activities of daily living (ADLs), specifically grooming and personal hygiene, for a resident who was unable to fully perform these tasks. The resident was an elderly female with age-related cognitive decline and polyosteoarthritis, and a Quarterly MDS showing a BIMS score of 09, indicating moderate cognitive impairment. Her care plan, revised on 03/13/2026, identified an ADL self-care performance deficit and included interventions for assistance with personal hygiene, including hair, shaving, and oral care as needed. On 03/30/2026 at 9:56 AM, the resident was observed with black hair on her upper lip and black and gray hair on her chin. She stated that she would shave herself if she could, but did not want to ask staff because she did not want to bother them. Staff interviews confirmed that grooming, including facial grooming, was generally performed on shower days, about two days per week, and that CNAs and nurses were responsible for monitoring and ensuring residents’ grooming. CNA A stated that facial grooming was done on shower days and that CNAs were to ask residents if they wanted facial hair shaved, acknowledging that long facial hair in female residents could affect self-esteem. LVN B similarly stated that residents were offered facial grooming on shower days and that nurses were responsible for ensuring residents were well groomed, noting that female residents with long facial hair could be emotionally affected or embarrassed. The DON and Administrator both reported that facial grooming should be done as needed and according to resident preference, and that all staff shared responsibility for ensuring residents were well groomed. Despite these stated responsibilities and the facility policy on dressing and personal grooming, the resident’s facial hair was not addressed, indicating that the facility did not implement the care plan interventions to assist with personal hygiene and grooming as required.
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