Failure to Provide Adequate Nail Care and Personal Hygiene
Penalty
Summary
A deficiency was identified when a resident, who was dependent on staff for all activities of daily living due to multiple medical conditions including chronic respiratory failure, tracheostomy, muscle wasting, diabetes, and psychosis, was not provided with adequate nail care. The resident's care plan specifically required staff to check, trim, and clean nails on bath days and as necessary, and to report any changes to the nurse. However, during an observation, the resident was found with long, dirty fingernails, some stained brown, and old, partially removed nail polish. The resident indicated through nonverbal cues that staff had not attempted to provide nail care, and staff interviews confirmed that the resident's nails were not properly maintained. Interviews with facility staff, including a CNA, the Director of Rehabilitation, and the DON, revealed that CNAs were responsible for nail care and that the resident's nails should have been cleaned, trimmed, and old polish removed. Staff acknowledged that the resident's nails were not in compliance with facility policy, which requires nail care to keep nails clean and trimmed. The failure to provide this care was directly observed and confirmed through staff interviews and record review.