Failure to Provide Fingernail Care for Dependent Resident
Penalty
Summary
A deficiency occurred when the facility failed to provide appropriate fingernail care for a resident with multiple diagnoses, including dementia, Parkinson's Disease, type 2 diabetes, and osteoarthritis. The resident was care planned for functional ability deficits and required assistance with self-care and mobility, as well as frequent re-approach for care refusals. Observations revealed that the resident's fingernails were approximately 1/2 inch past the fingertips and contained a black substance underneath. The resident reported that it had been a couple of months since his fingernails were last cut or cleaned by staff, and that he had not attempted to care for his own nails. He also stated he was told by a nurse aide that only a nurse could trim his nails due to his diabetes, but no action was taken to address his nail care needs. Interviews with the assigned nurse aide and nurse confirmed that while nail care was part of the shower routine, the aide did not notice the condition of the resident's nails and did not report the need for nail care to the nurse. The nurse was unaware of the resident's nail condition and had not attempted to trim the nails prior to being informed. The resident also reported not being offered nail care during refusals of showers or baths, and the nurse aide did not communicate the need for nail care to the nurse. Facility policy required that long nails of diabetic residents be reported to a nurse for appropriate care, but this was not followed, resulting in the resident's fingernails remaining untrimmed and uncleaned for an extended period.