Failure to Provide Adequate Nail Care for a Resident
Penalty
Summary
The facility failed to provide adequate nail care for a resident, identified as Resident #119, who was admitted with a medical history of cerebrovascular disease, weakness, and type 2 diabetes mellitus. The resident's care plan indicated a need for assistance with activities of daily living (ADLs) due to a self-care performance deficit. Despite documentation showing that personal hygiene and bed baths were provided on specific dates, observations revealed that the resident's fingernails were soiled on multiple occasions. Interviews with staff, including a CNA and an LVN, confirmed that nail care was expected to be part of the ADL routine, yet the resident's nails remained dirty. The facility's policy on nail care, revised in 2018, required daily cleaning and regular trimming to prevent infections. However, the CNA responsible for the resident admitted to checking the resident's nails daily but did not ensure they were clean. The LVN and Interim Director of Nursing also acknowledged the expectation for nail care but were unsure of the documentation process. The Interim Administrator confirmed that nail care should be performed during showers, baths, and as needed, yet the resident's nails were not maintained according to these standards.