Failure to Provide Consistent Nail Care for Dependent Resident
Penalty
Summary
A deficiency was identified when a resident with diagnoses including rheumatoid arthritis, lupus, and repeated falls, who required assistance with personal hygiene and nail care, was observed to have long fingernails with visible debris underneath. The resident's care plan and care card indicated a need for assistance with nail care due to self-care deficits and impaired mobility, and the resident was scheduled for biweekly showers with nail care attached to one of the shower days. Despite this, observations on two separate occasions revealed the resident's nails were 0.6-0.7 inches long with debris present, and the resident reported not refusing nail care and being unable to recall the last time their nails were cleaned, cut, or filed. Interviews with staff revealed uncertainty regarding the facility's nail care policy and a lack of clear documentation or recall of when nail care was last provided to the resident. While recreation staff could clean and paint nails, they were not permitted to cut them and would notify nursing staff if cutting was needed. Facility documentation showed some nail care was provided and one refusal was recorded, but weekly skin checks did not identify any concerns with the resident's nails. The facility's policy required necessary services for residents unable to perform activities of daily living, including grooming and personal hygiene, but this was not consistently implemented for the resident in question.