Failure to Provide Nail and Grooming Care for Dependent Resident
Penalty
Summary
A resident with moderate cognitive impairment, impaired mobility, and a self-care deficit requiring assistance with all activities of daily living (ADLs) did not receive appropriate nail care. The resident was observed on multiple occasions to have long, irregular fingernails that extended past the fingertips, with dark matter occasionally visible under the nails. The resident expressed dissatisfaction with the length of his fingernails, stating they sometimes got caught on his sheets, and reported being unable to shave due to not having an appropriate razor. Despite having requested an electric razor weeks prior, the resident had not received one. The care plan indicated the resident was at risk for excessive bruising and bleeding due to the use of a blood thinner, and required assistance with all ADLs, including grooming and nail care. Interviews with staff confirmed that nail care should be completed on bath days or as needed, and that assistance with grooming was expected daily. Staff acknowledged that the resident's nail care had not been performed as required, and that documentation and follow-up were lacking when care was refused or not completed. Facility policy stated that necessary services for ADLs, including bathing and grooming, would be provided for residents unable to complete these tasks. The deficiency was identified through observation, resident and staff interviews, and review of care plans and facility policy.