Failure to Provide Routine Nail Hygiene for Dependent Resident
Penalty
Summary
A deficiency was identified when a resident with severe cognitive impairment and multiple medical diagnoses, including hyperlipidemia, anemia, a history of falls, a left arm fracture, and pneumonia, did not receive routine personal hygiene care, specifically nail hygiene. The resident was dependent on staff for personal hygiene, as documented in the Minimum Data Set and medical records. During observations, the resident was seen with black residue under the fingernails on multiple occasions, including while eating breakfast with his hands. The resident reported that staff had not offered to clean or cut his fingernails. Interviews with facility staff confirmed that the resident's nails were dirty and unkempt, and that this was recognized as a dignity issue and a potential source of infection. The facility's policy required that residents be groomed according to their wishes, including nail care, to promote dignity and quality of life. Despite these requirements, the resident did not receive the necessary nail hygiene assistance, resulting in a failure to maintain the resident's dignity and personal hygiene needs.