Failure to Provide Necessary Nail Care for Dependent Residents
Penalty
Summary
The facility failed to provide necessary care and assistance with activities of daily living (ADLs) for two residents who were unable to perform self-care, specifically in the area of grooming and personal hygiene related to fingernail care. Both residents had documented needs for staff assistance with ADLs, including nail care, as outlined in their care plans. Despite these interventions, observations revealed that both residents had long fingernails, and staff acknowledged the issue but did not ensure the nails were trimmed in a timely manner. Resident 60 was admitted with hemiplegia and hemiparesis following a cerebral infarction, resulting in dependence on staff for self-care. The care plan for this resident included checking and trimming nails on bath days as necessary. However, during observations, Resident 60 was found with long fingernails while being dependent on a ventilator and feeding tube. Staff interviews confirmed awareness of the long nails but cited the absence of nail clippers as a reason for not addressing the issue. Resident 142, admitted with diagnoses including malignant neoplasm of the tongue and systemic lupus erythematosus, also required assistance with personal care and had moderate cognitive impairment. Observations and interviews indicated that this resident had long fingernails and expressed a preference for shorter nails, but staff had not offered to trim them. Facility policies and procedures reviewed emphasized the importance of regular nail care for hygiene and infection prevention, and staff interviews confirmed their responsibility for maintaining residents' fingernails, yet the necessary care was not provided.