Failure to Maintain Resident Nail Hygiene as Required by Care Plan
Penalty
Summary
The facility failed to ensure that a resident's fingernails were kept clean and trimmed, as required by the resident's care plan and facility policy. The resident, who had a diagnosis indicating a need for assistance with personal care and demonstrated moderately impaired cognition, required substantial to maximal assistance with personal hygiene. Observations revealed that the resident's fingernails were long and had dark debris underneath, and the resident had multiple scratches and open skin areas on both arms and abdomen. The resident reported frequent itching and a desire to have his fingernails trimmed. Staff interviews confirmed that the resident's fingernails were supposed to be kept short and clean to prevent infection and injury, especially given the resident's history of picking and scratching at his skin. The care plan specifically included interventions to keep the resident's nails short to reduce the risk of skin injury and infection. However, the care plan was not followed, as acknowledged by the Infection Control Preventionist, and the facility's policy on nail care, which requires daily cleaning and regular trimming, was not implemented for this resident.