Failure to Provide Toenail Care for Dependent Resident
Penalty
Summary
The facility failed to provide necessary toenail care for a resident who was unable to perform this activity independently. The resident, who had diagnoses of type 2 diabetes without complications and dementia, reported that her toenails had become very long and caused her pain while walking. She stated that the podiatrist, who usually trimmed her toenails, had not visited for an extended period due to scheduling issues. The resident had communicated her concerns to the Social Service Director. Observation confirmed that the resident's toenails were excessively long, with irregular edges and thickening, and a callous was present on her foot. Record review showed no documentation of hygiene care refusal or mention of long toenails in recent skin evaluations. The Regional Nurse Consultant acknowledged that the resident's nails were excessively long and should have been trimmed, noting that both nurse aides and nurses are responsible for identifying and addressing such issues during daily care and weekly skin checks. The last podiatry visit was in February, and the scheduled April visit did not occur. Facility policy requires that residents unable to perform activities of daily living receive necessary services to maintain good grooming, which was not met in this case.