Failure to Provide Nail Care for Dependent Resident
Penalty
Summary
A deficiency was identified when a dependent resident, who required maximum assistance for activities of daily living (ADLs) due to severe cognitive impairment and diagnoses including dementia and protein-calorie malnutrition, was observed on multiple occasions to have excessively long and discolored fingernails. The resident's nails extended one fourth to one third of an inch beyond the fingertips and appeared light brownish in color. Despite being non-responsive to interview questions, the resident's condition was confirmed by both a certified nurse assistant (CNA) and a unit nurse manager/licensed practical nurse (LPN), who acknowledged that the nails needed to be trimmed and cleaned. A review of the resident's electronic medical record (EMR) indicated that daily ADL care, including nail care, was documented as provided over the past thirty days, with no significant behavioral resistance noted. The facility's policy required grooming tasks such as nail trimming for residents needing extensive assistance. However, the observed state of the resident's nails and staff interviews revealed that appropriate nail care was not performed as required, despite documentation suggesting otherwise.