Failure to Provide Routine Nail and Hygiene Care
Penalty
Summary
The facility failed to provide proper hygiene and grooming care for a resident who was unable to perform these activities independently. The resident, who had a history of difficulty walking, chronic heart failure, and a previous transient ischemic attack, was observed to have long, thickened, yellow toenails curling over the tips of both feet, as well as long, untrimmed fingernails. The resident reported having requested nail trimming from staff multiple times without receiving assistance and stated he had not been seen by a podiatrist since admission. Observations by staff confirmed the condition of the resident's nails and dry, cracked skin on the feet. Review of the resident's records showed a physician's order for a nail care appointment and documentation of a podiatry visit, but there was no evidence of follow-up or routine nail care by nursing staff as required by facility policy. The Assistant Director of Nurses acknowledged that the resident was not diabetic and that nail care should have been performed by CNAs or licensed nursing staff as part of routine grooming. The facility's policy indicated that routine foot care, including nail trimming, should be managed by licensed nurses, but there was no documentation explaining the delay or lack of care. Staff failed to identify and address the resident's hygiene needs during routine assessments, resulting in the deficiency.