Failure to Follow Physician Orders and Provide Basic Nail Care
Penalty
Summary
The facility failed to follow physician orders and provide basic care for a resident with multiple medical conditions, including chronic kidney disease, osteoarthritis, repeated falls, muscle disorder, abnormal gait, anemia, zoster, major depressive disorder, and dementia. The physician order sheet specified that compression stockings were to be applied to both lower extremities in the morning and removed at night to address edema. However, during multiple observations, the resident was found with swollen legs exhibiting moderate pitting edema and was not wearing the prescribed compression stockings. The resident confirmed that staff were not applying the stockings as ordered. Additionally, the resident's care plan required staff assistance with personal hygiene, including checking, trimming, and cleaning fingernails on bath days and as necessary. Despite this, shower records did not indicate that nail care was provided, and the resident was observed with long fingernails containing a moderate amount of black dry debris. The resident stated that their nails had not been cleaned, and the administrator verified the presence of debris, acknowledging that nail care should have been performed during the most recent shower.