Failure to Provide Ordered Consultations and Nail Care
Penalty
Summary
The facility failed to provide care and services in accordance with professional standards for a resident with multiple diagnoses, including major depressive disorder, schizophrenia, adult failure to thrive, and a need for assistance with personal care. The resident required partial to maximal assistance with personal hygiene, bathing, and toileting. Observations revealed that the resident had long fingernails on several digits, with overgrowth of skin and dryness around the nails. The assistant director of nursing confirmed that the resident's fingernails were long and needed trimming, and facility policy indicated that proper nail care is necessary to prevent skin problems. Additionally, the facility did not follow through on physician orders for psychiatric and dermatology consultations for the resident. Although orders for these consults were documented, interviews with staff, including an LVN, the social service assistant, and the director of nursing, confirmed that there was no evidence the consultations had been completed or documented in the resident's clinical record. The staff acknowledged that the orders should have been followed and arrangements made for the resident to be seen by the appropriate specialists.