Failure to Provide Nail Care for Dependent Residents
Penalty
Summary
The facility failed to provide adequate nail care for two residents who were dependent on staff for activities of daily living. One resident, with severe cognitive impairment and multiple diagnoses including Alzheimer's disease and cerebral palsy, was observed on multiple occasions to have untrimmed nails extending beyond the fingertips with a black substance underneath. Despite the care plan specifying nail care twice weekly on bath days, and documentation indicating nail care was completed, direct observation contradicted these records. A family member also reported repeated requests for nail care that were not addressed. Another resident, also with severe cognitive impairment and multiple diagnoses, was observed to have overgrown, unkempt nails with sharp, broken edges and a black dirt-like substance underneath. Documentation for this resident did not indicate that nail care was completed as required. Interviews with nursing staff revealed that while nursing assistants were responsible for documenting nail care on bath sheets, licensed nurses did not verify whether the care was actually provided, relying solely on the documentation submitted. The facility was unable to provide a policy regarding nail care during the survey.