Failure to Provide Adequate Nail Care Resulting in Self-Inflicted Skin Lesions
Penalty
Summary
A deficiency was identified when a resident who required staff supervision for personal hygiene and grooming did not receive adequate nail care. During observations, the resident was seen scratching her face, neck, and arms, resulting in multiple small red lesions. The resident's fingernails were noted to be long, with black stains and food residue underneath. The care plan for this resident specifically included an intervention to keep fingernails short due to a history of self-inflicted excoriations. However, documentation showed that the last time the resident's fingernails were clipped was over a month prior, and there was no record of nail care being offered since then. Interviews with staff confirmed that providing nail care was a CNA responsibility and that the resident's care plan should have been followed. Both the CNA and LVN verified the resident's nails were long and dirty, which contributed to skin impairment. The ADON acknowledged that failure to provide personal hygiene and grooming, including nail care, could affect the resident's dignity and potentially lead to bacterial growth. The facility's policy required assistance with activities of daily living, including grooming and hygiene, for residents unable to perform these tasks independently.