Failure to Provide Adequate Nail Care for Dependent Residents
Penalty
Summary
The facility failed to provide adequate nail care to three out of four sampled residents who were unable to perform activities of daily living independently. Observations revealed that one cognitively intact resident had long nails and reported that staff only cleaned her nails, though she sometimes wanted them cut. Another resident, who was moderately cognitively impaired and required set-up assistance for personal hygiene, was observed with dirt-encrusted and unkempt nails. A third resident, who was severely cognitively impaired and required dependent assistance, was also observed with heavily dirt-encrusted nails. Interviews with staff indicated that certified nursing assistants (CNAs) were responsible for providing nail care, but there was no consistent schedule or time frame for this care, with staff stating it was done "as needed" or approximately every three days. Staff members acknowledged during observations that the residents' nails were dirty and needed attention. The facility's policy required that residents unable to perform activities of daily living receive necessary services to maintain grooming and hygiene, but this was not consistently implemented for the residents observed.