Failure to Provide Required Nail Care for Dependent Residents
Penalty
Summary
The facility failed to provide adequate assistance with nail care for three out of five sampled residents who required help with activities of daily living (ADLs). Observations and interviews revealed that these residents had long, untrimmed fingernails or toenails, with one resident having visible debris and crusted areas on their feet, and another with nails digging into their wrist and palm. Staff interviews confirmed that nail care had not been performed as required, and residents reported that their nails had not been trimmed or cared for since admission. Care plans for all three residents indicated a need for assistance with personal hygiene and ADLs, but this assistance was not provided. The residents involved had significant medical conditions, including diabetes with poor wound healing, paraplegia, hemiplegia, hemiparesis, and chronic leg weakness, which increased their dependence on staff for personal care. Facility policy required daily cleaning and regular trimming of nails to prevent infection and injury, and staff were expected to check and provide nail care on shower days. Despite these policies, staff and the Director of Nursing acknowledged that nail care was not consistently performed, resulting in residents being left with long, untrimmed nails.