Failure to Provide Skin and Nail Care for Dependent Resident
Penalty
Summary
Facility staff failed to provide necessary assistance with activities of daily living (ADLs) for a dependent resident, specifically regarding skin and nail care. Multiple observations over several days revealed that the resident's fingernails were dirty and long, and her feet were dry and scaly with skin flakes accumulating on her bed sheet. The resident, who had severe cognitive impairment and was dependent on staff for ADLs and transfers, expressed that she did not want her fingernails to be long and would like lotion applied to her feet. Her medical record included diagnoses of diabetes and heart failure, and a recent podiatry note documented extremely dry, scaly skin on more than 60% of her feet, indicating a need for at-risk foot care. Review of shower sheets from the previous 30 days showed no documentation that skin and nail care was completed or refused. The Director of Nursing was informed of these findings and did not provide additional information.