Failure to Provide Adequate Nail Care for Dependent Residents
Penalty
Summary
The facility failed to provide necessary assistance with activities of daily living (ADLs), specifically in maintaining good grooming and personal hygiene for four residents who were unable to perform these tasks independently. Observations and interviews revealed that these residents had long, dirty fingernails that had not been cleaned or trimmed as required. In each case, the residents either expressed discomfort with the condition of their nails or were unable to recall when they were last trimmed, and staff were either unaware of the issue or had not addressed it. Resident assessments and care plans indicated that these individuals had significant cognitive or physical impairments, such as hemiplegia, dementia, or other conditions requiring staff assistance with personal hygiene. Despite these documented needs, staff did not ensure that nail care was performed regularly. Interviews with CNAs, nurses, and administrative staff confirmed that there was a lack of consistent monitoring and follow-through regarding nail care, with some staff unaware of their responsibilities or the current condition of the residents' nails. Facility policy required regular nail care to prevent infection and injury, with specific instructions for staff roles based on resident diagnoses such as diabetes. However, observations showed that these policies were not consistently implemented, as evidenced by the presence of long, discolored, and dirty fingernails on multiple residents. Staff interviews further revealed gaps in communication and accountability regarding nail care duties.