Failure to Provide Adequate Fingernail Care
Penalty
Summary
The facility failed to provide adequate fingernail care for a resident with severe cognitive impairment and multiple health conditions, including Type 2 Diabetes and psychomotor deficits. The resident required substantial assistance for personal hygiene, as documented in their care plan. Despite this, the resident's family member observed a large amount of black substance with a strong odor under the resident's fingernails, indicating neglect in nail care. The family member reported having asked for nail cleaning for two weeks without any action taken by the staff. Interviews with various Certified Nursing Assistants (CNAs) and the Director of Nursing revealed inconsistencies in the facility's approach to nail care. CNAs stated that nail cleaning typically occurs during showers, which are scheduled twice a week, but none could recall when they last cleaned the resident's nails. The Director of Nursing admitted there was no specific schedule for nail care, and it was dependent on staffing levels. The facility's policy on nail care, which emphasizes regular cleaning and trimming to prevent infections, was not adhered to, as evidenced by the lack of documentation on the resident's shower sheets regarding nail care.