Failure to Provide Required Nail Care for Dependent Resident
Penalty
Summary
The facility failed to provide necessary grooming care for a resident who was dependent on staff for activities of daily living (ADLs). The resident, who had a diagnosis of unspecified dementia and was assessed as having severely impaired cognition, required partial to moderate assistance with personal hygiene. Observations revealed that the resident's fingernails were excessively long, curled inward, and had a brown substance underneath. Despite the facility's policy requiring staff to clean and trim nails on shower days, there was no documentation that this task had been completed for the resident over a 30-day period. The CNA Kardex specified that nail care should occur on designated shower days, but CNA documentation did not show that the task was performed. Interviews with staff confirmed the lack of clarity regarding responsibility for nail care and the absence of documentation. The resident expressed that no one had come to cut her nails and was unable to recall the last time they were trimmed. Staff members, including a CNA, RN, and the Activities Director, acknowledged that the resident's nails were too long and that nail trimming was not being performed as required. The Administrator also confirmed that, according to the Kardex, the task should have been completed by nursing assistants.