Failure to Provide Adequate Nail and Hygiene Care for Dependent Resident
Penalty
Summary
Resident #145, who had diagnoses including cerebral palsy, major depressive disorder, and dementia, was observed on multiple occasions with long, untrimmed fingernails containing brown and black debris underneath. The resident was assessed as having severe cognitive impairment and was dependent on staff for most activities of daily living, including personal hygiene. Facility documentation, including the care plan and Kardex, indicated that the resident required maximum assistance with all hygiene needs and did not refuse care. Despite these documented needs, staff interviews revealed that nail care was expected to be provided on shower days and as needed, but was not consistently performed. Certified nurse aides responsible for the resident's care did not notice or address the unclean and long fingernails, even though they acknowledged the importance of nail care for hygiene and infection control. The facility's policy required nail care to be provided as needed, but this was not followed for the resident, resulting in the observed deficiency.