Failure to Provide Required Nail Care for Dependent Resident
Penalty
Summary
A deficiency was identified when a resident who required substantial assistance with activities of daily living (ADLs) was observed to have long and unkempt toenails while lying in bed. The resident, who had intact cognition as indicated by a BIMS score of 14, reported that since being taken off hospice, no one had trimmed their toenails, resulting in discomfort. Facility records, including a CNA Bathing Review form, had previously noted the need for toenail trimming. Interviews with CNAs revealed uncertainty about whether the resident was diabetic, which affected whether they would trim the toenails or refer the task to a nurse. The facility's policy required nail care to be provided to residents, with nurses responsible for ensuring appropriate care, but this was not carried out for the resident in question.