Failure to Provide Nail Care for Dependent Resident
Penalty
Summary
Facility staff failed to provide adequate nail care services for a dependent resident, as evidenced by repeated observations over three consecutive days where the resident had a large amount of a brown substance under the fingernails of both hands. Staff interviews confirmed that the resident's nails appeared dirty and had not been cleaned recently. The Director of Nursing stated that dependent residents are expected to have their nails cleaned as part of their activities of daily living (ADL) care. The resident in question had medical diagnoses including muscle weakness, dementia, and osteoarthritis, and was assessed as having severe cognitive impairment with a BIMS score of 00. The resident was documented as being dependent on staff for showers, bathing, and personal hygiene, and had a care plan indicating self-care deficits related to cognitive impairment. Facility policy required regular cleaning and trimming of nails to maintain dignity, but this was not followed for the resident.