Failure to Provide Nail Care for Dependent Resident
Penalty
Summary
A resident who was dependent on staff for personal hygiene was observed to have long, jagged, and dirty fingernails with debris, and reported needing their nails cut. The resident stated they had received a bed bath over the weekend, but their fingernails remained untrimmed and unclean over several days of observation. Staff confirmed the resident's nails were long and dirty, and the resident agreed to have them trimmed when asked. The resident's medical record indicated diagnoses including venous insufficiency and chronic ulcers, and a moderate cognitive impairment, requiring dependent assistance for personal hygiene. The care plan specified nail care was to be provided twice a week on shower days and as needed, but there was no documentation of refusals for nail care or bed baths in the electronic medical record for the relevant period.
Plan Of Correction
F 677 ADL Element #1 Resident #41 was provided nail care. Element #2 Current residents have the potential to be affected by the deficient practice. Current residents were assessed for the need of nail care. Any residents without nail care completed were provided nail care and documented in the electronic medical record. Refusals and preferences were documented in the electronic medical record and care plan was updated accordingly. Element #3 The policy, Nail Care Policy, has been reviewed and deemed appropriate. The policy remains in place. CNA s, Licensed Practical Nurses & Registered Nurses were re-educated on the policy for Nail Care Policy with emphasis on routine cleaning and inspection. Element #4 The Director of Nursing and/or designee will conduct random audits of 5 residents to ensure substantial compliance with nail care. Audits will be conducted weekly for four weeks then monthly for two months. Any concerns will be immediately addressed. The results of the audits will be reviewed by the QAPI committee monthly for 3 months for further recommendations. Any area of non-compliance will be addressed. The Administrator is responsible for sustained compliance. Date of Compliance: 7/8/2025