Failure to Provide Adequate Nail Care to a Dependent Resident
Penalty
Summary
The facility failed to provide adequate nail care to a dependent resident, resulting in an unkempt appearance and potential for infection. Resident #52, who was severely cognitively impaired and dependent on staff for activities of daily living (ADLs), was observed multiple times with long, dirty fingernails caked with black debris. Despite the resident's expressed preference for clean and trimmed nails, staff did not provide the necessary care. The care plan indicated that Resident #52 required extensive assistance with ADLs, including nail care. Interviews with staff revealed inconsistencies in the provision of nail care, with some CNAs stating it should be done during showers, while others indicated it could be done anytime. An LPN acknowledged the need for nail care but left the resident's room without completing it, citing time constraints. The Director of Nursing expected nails to be clean and trimmed as needed, but there was no documentation of nail care in the resident's records. This lack of consistent care and documentation contributed to the deficiency identified by surveyors.
Plan Of Correction
Element #1: Nail care was provided for Resident #52. Element #2: Residents' dependent for fingernail grooming/hygiene have the potential to be affected. These Residents who are dependent for fingernail grooming/hygiene will be observed for appropriate fingernail grooming/hygiene and any concerns will be addressed at time of observation. Element #3: Certified Nursing Assistants and Licensed Nurses will be re-educated on ADL standards of care. Element #4: Under the direction of the Quality Assurance Performance Improvement (QAPI) Committee, Nurse Manager, or designee(s), will randomly audit dependent residents for ADL standards of care. The QAPI Committee will review findings monthly and determine ongoing need for audits. Element #5: The Administrator is responsible for sustained compliance.