Failure to Provide Nail Care for Dependent Residents
Penalty
Summary
The facility failed to provide necessary assistance with activities of daily living (ADLs) related to nail care for two residents who were dependent on staff. One resident, a male with a history of cerebrovascular accident, muscle weakness, and moderate cognitive impairment, was observed with long fingernails containing brown matter underneath. He reported that he had requested staff assistance to clean and trim his nails, but this was not done. His care plan included interventions for nail care to be performed on bath days and as needed, but these interventions were not followed. Another resident, a male with diabetes, anxiety, bipolar disorder, and schizophrenia, was found to have long, cracked toenails. He was totally dependent on staff for ADLs and was unsure who could safely trim his toenails due to his diabetic condition. His care plan specified that nail care, particularly for diabetic residents, should be provided by a nurse, and a podiatry consult was available as needed. Observations and interviews with staff confirmed that nail care responsibilities were not carried out as required, and the process for referring diabetic residents for podiatric care was not followed.