Failure to Provide Personal Hygiene and Nail Care for Dependent Resident
Penalty
Summary
A deficiency was identified when a resident who was dependent on staff for personal hygiene, including nail care, was repeatedly observed with long, untrimmed fingernails pressing into the palm of the left hand. The resident had significant medical conditions, including cerebral infarction, dementia, above-knee amputation, and legal blindness, and was documented as having limited dexterity and range of motion. Despite care plans indicating the need for staff to check, trim, and clean nails on bath days and as necessary, the resident's nails remained untrimmed over several days of observation. The clinical record and CNA documentation showed only a few instances of documented refusal of personal hygiene, and there was no documentation of refusal of nail care specifically. Interviews with staff revealed that while the resident was known to refuse some care, nail care was not consistently offered or documented as refused. The resident reported that staff had only occasionally asked to trim his nails and that he was unable to do so himself. Staff interviews confirmed the resident's nails were long and needed trimming, and that the resident had not refused nail care. The care plan addressed refusal of some care but did not specifically address nail care refusals, and staff did not consistently document or address the ongoing need for nail care.