Failure to Provide Adequate Nail Care and Hygiene for Dependent Resident
Penalty
Summary
A deficiency was identified when a resident with severe cognitive impairment, autism, and dementia, who was dependent on staff for most activities of daily living (ADLs), was not provided adequate care and services to maintain good grooming and personal hygiene. The resident was observed with untrimmed fingernails that had sharp edges, a pea-sized bruise near the left eye, and scratches on the right forehead. Staff interviews confirmed that nail care was part of their responsibilities and that the resident's fingernails should have been assessed and trimmed regularly to prevent self-injury. Further review revealed that there was no care plan addressing the resident's behavior of self-scratching or specific interventions for nail care. The facility's Director of Nursing confirmed the absence of a care plan for these issues and acknowledged that the facility did not have a policy and procedure specific to nail care, relying instead on a general ADL policy. The lack of individualized care planning and oversight led to the resident being at risk for skin injuries from untrimmed nails.