Failure to Provide Nail Care for Dependent Resident with Contracture
Penalty
Summary
The facility failed to provide necessary assistance with activities of daily living (ADLs) for a resident who was dependent on staff for care. The resident, who had multiple sclerosis and right-sided hemiplegia with a contracted hand, was observed on multiple occasions with fingernails on the right hand that were approximately one inch long and pressing into the palm. The resident was unable to recall the last time their nails were trimmed, and staff interviews confirmed that the resident was totally dependent on staff for ADLs, including nail care. The care plan and Kardex both indicated the need for extensive to total assistance with personal hygiene, including grooming. Despite documentation that grooming care was provided daily, direct observation and staff interviews revealed that the resident's fingernails had not been trimmed as required. Staff, including CNAs, a nurse, the Director of Rehab, and the DON, all acknowledged that the resident's nails were excessively long and should have been cut, especially given the hand contracture. The facility's policy required staff to maintain residents' grooming and personal hygiene, but this was not followed for this resident, resulting in a failure to meet the resident's ADL needs.