Failure to Provide Timely Nail Care for Dependent Resident
Penalty
Summary
A deficiency was identified when a resident with severe cognitive impairment, blindness, and multiple medical diagnoses, including hyperlipidemia, seizure disorder, cataracts, glaucoma, and macular degeneration, did not receive necessary assistance with personal hygiene, specifically nail care. The resident required partial to moderate staff assistance for personal hygiene, as documented in the care plan, which included regular nail care. Observations on two consecutive days revealed the resident's fingernails were about a half-inch long, and the resident expressed discomfort and a desire to have his nails cut. Interviews with staff indicated confusion regarding responsibility for nail care, particularly concerning whether the resident was diabetic, which would require a nurse rather than a CNA to perform the task. The CNA assigned to the resident did not check or trim the resident's nails during scheduled showers, and the DON confirmed that nail care should be provided at least weekly by CNAs unless the resident is diabetic. The facility's nail care policy outlined the procedure for nail care, but it was not followed in this instance, resulting in the resident's nails remaining untrimmed.