Failure to Provide Personal Hygiene and Nail Care for Dependent Resident
Penalty
Summary
A deficiency occurred when a resident with type 2 diabetes, muscle weakness, and moderate cognitive impairment was found to have long fingernails with black particles underneath, indicating a lack of personal hygiene care. The resident required substantial to maximal assistance with activities of daily living, including upper body dressing, and expressed concern about the risk of injury or scratching herself due to the length of her fingernails. She stated that her fingernails were kept short at home and that she preferred them that way, but the facility had not offered to cut them. Interviews with staff revealed confusion regarding responsibility for nail care, particularly for diabetic residents. Certified Nursing Assistants (CNAs) believed that nurses were responsible for cutting fingernails for diabetic residents, while CNAs were expected to file and clean nails weekly. Both the CNA and a Licensed Vocational Nurse (LVN) acknowledged that the resident's fingernails were dirty and that there was no documentation or log indicating that nail care had been performed as required. The Director of Nursing confirmed that nurses should cut fingernails for diabetic residents and that documentation was lacking. Facility policy required assistance with personal hygiene for residents unable to perform these tasks independently, but this was not followed in the resident's case.