Failure to Provide Required Nail Care for Dependent Resident
Penalty
Summary
The facility failed to provide adequate activities of daily living (ADL) care, specifically nail care, for a dependent resident. According to the facility's policy, morning care should include nail care as needed. The resident in question was admitted with diagnoses including chronic obstructive pulmonary disease (COPD) and was assessed as having moderate cognitive impairment, requiring staff assistance for ADLs. On observation, the resident was found to have ten fingernails with a thick grayish brown substance beneath each nail, indicating a lack of proper nail hygiene. Further investigation included interviews with staff, who confirmed that personal hygiene, including nail care, was expected to be provided to all residents as needed. An LPN was observed removing debris from the resident's fingernails, and the resident expressed a preference for clean nails. The DON and other staff acknowledged that nail care was part of expected resident care, but the resident had not received this care as required, resulting in the deficiency.