Failure to Provide Adequate Nail Care to Residents
Penalty
Summary
The facility failed to provide adequate nail care to residents who were unable to perform activities of daily living independently. This deficiency was observed in two residents, both of whom had long, jagged nails with a brown substance underneath. One resident, who was severely cognitively impaired and had physical limitations due to a cerebrovascular accident, was observed multiple times with untrimmed nails and reported that staff did not cut their nails. The resident required maximal assistance with personal hygiene, as documented in their care plan. Another resident, who was cognitively intact but had general weakness and lack of coordination, also had long, unkempt nails. This resident expressed dissatisfaction with the state of their nails and mentioned that they had to request staff assistance for nail care. The care plan for this resident indicated a need for maximal assistance with personal hygiene, yet the resident's nails remained untrimmed during the surveyor's observations. Interviews with facility staff, including CNAs and an LPN, revealed inconsistencies in the process for providing nail care. Staff indicated that nail care was part of morning care and required nurse approval before trimming. However, documentation of nail care was not readily available, and staff acknowledged the importance of nail care for hygiene and safety. The facility's policy stated that residents unable to perform ADLs independently should receive necessary services, including grooming, but this was not consistently implemented for the residents in question.
Plan Of Correction
Rose Mountain Care Center Facility ID 315384 F677 SS D **Element One - Corrective Action:** Residents #19 and #33 had NEXTRY 20-40 completed on 12/12/24. **Element Two - Identification of at Risk Residents:** All residents that are dependent on their activities of daily living (ADL) are at risk. A facility-wide audit was completed on all dependent residents to ascertain grooming including nails on 12/12/24. **Element Three - Systemic Changes:** All clinical staff were re-educated on ensuring residents are groomed, including nail care on 12/12/24. **Quality Assurance:** To maintain and monitor ongoing compliance, Unit Managers/designees will audit 3 dependent residents per day per unit daily x 5 days, weekly x 4 weeks, and monthly x 4 months to ensure residents' hygiene including nail care is completed. Needed corrections will be addressed as they are discovered. Findings to be reported to the Quality Assurance Performance Improvement team for review and action as necessary. **Date of Completion:** 12/25/24