Failure to Provide Adequate Nail Care for Dependent Resident
Penalty
Summary
The facility failed to provide necessary assistance with grooming and personal hygiene for a resident who was dependent on staff for such care. The resident, who had a history of cerebral vascular accident with right-sided hemiplegia, malnutrition, and failure to thrive, was observed with long fingernails filled with brown debris over an extended period. Despite the facility's policy requiring nail care on shower days, the resident's nails were not attended to, leading to discomfort and frustration as expressed by the resident during interviews. Observations on multiple occasions revealed the resident eating with unclean nails, which were not trimmed or cleaned as per the care plan. Interviews with staff, including a Registered Nurse Manager and the Director of Nursing, confirmed that nail care should have been performed on the resident's designated shower day or as needed. However, this care was not provided, and there was no documentation of any resident refusals or care planning adjustments, indicating a lapse in adhering to the facility's policies and care plan requirements.
Plan Of Correction
Plan of Correction: Approved March 10, 2025 1. Immediately assessed and provided nail care to the resident affected. Checked for any sign of infection, overgrowth, or discomfort. 2. Identified residents who require routine or specialized nail care. Referred any residents with advanced nail care concerns to a podiatrist for further treatment. 3. Train nursing staff on proper nail care procedures, policy, hygiene importance, and documentation. Integrated nail care checks with all weekly showers. 4. Weekly nail care audits will be conducted on all units. These results will be presented to the QA committee for review. The committee will determine the frequency of the audit thereafter. Responsible: Director of Nursing