Failure to Provide Required Nail Care for Dependent Resident
Penalty
Summary
A deficiency was identified when a resident with moderately impaired cognition, hemiplegia, hemiparesis, and vascular dementia was not provided with necessary nail care assistance. The resident required staff help with most activities of daily living (ADLs) due to impairment on one side of the upper extremities. Despite care plan documentation indicating the need for assistance and multiple staff interviews confirming that nail care should be performed weekly on bath day, observations revealed that the resident's fingernails were approximately an inch long and had not been trimmed for several weeks. The resident expressed a desire to have his nails cut, but this was not addressed. Staff interviews indicated confusion regarding responsibility for nail care, with varying responses about whether nursing assistants, nurses, or activities staff were responsible, particularly for diabetic residents. Documentation and skin assessments for the month did not indicate that nail trimming was necessary, and there was no record of refusals or completed nail care. Facility policy required that residents unable to perform ADLs receive necessary services to maintain grooming and hygiene, but this was not followed in the resident's case.