Failure to Provide Required Fingernail Care During ADL Assistance
Penalty
Summary
A deficiency was identified when a resident with diagnoses including dementia, anxiety disorder, and depression, who was dependent on staff for activities of daily living (ADLs) such as showering and personal hygiene, did not receive appropriate fingernail care. The resident's care plan specified the need for assistance with bathing due to self-care performance deficits related to deconditioning and multiple comorbidities. Physician's orders directed staff to provide showers on specific days. Despite these directives, observations on two consecutive days revealed that the resident's fingernails were long and not trimmed by choice, with the resident expressing a preference for having their nails cut. Further review of the Treatment Administration Record indicated that a shower had been documented as provided, but subsequent observation and interview with an LPN confirmed that the resident's fingernails remained long with dark brown debris underneath. The LPN acknowledged that nail care should have been performed during the shower and could not explain why it was omitted. Facility policy required that residents unable to perform ADLs independently receive necessary services to maintain good grooming and hygiene, which was not followed in this instance.