Failure to Provide Adequate Nail and Device Hygiene for Dependent Residents
Penalty
Summary
The facility failed to provide adequate care and assistance with activities of daily living for two residents who were unable to perform these tasks independently. One resident with depression, left-sided weakness, and cognitive impairment had long, jagged, and dirty fingernails, with some nails curled inward and showing a fungus-like appearance. The resident reported requesting nail care from staff, but it was not provided. Observations by staff confirmed the poor nail condition, and the nurse acknowledged the need for a physician's order for treatment. The DON stated that nurses are expected to provide nail care and notify the physician if there are signs of fungal infection. Another resident, who had undergone cervical spinal fusion and was required to wear a neck brace at all times, was observed with a neck collar foampad that was discolored and dirty. The resident stated that the foampad had not been cleaned or changed since admission, and staff confirmed the lack of cleaning. The DON indicated that regular cleaning of the foampad is necessary to prevent skin irritation and infection. Facility policies reviewed indicated that residents unable to perform activities of daily living should receive assistance to maintain good grooming and hygiene, and that resident care equipment should be cleaned regularly.