Failure to Provide Adequate Nail Care During ADL
Penalty
Summary
The facility failed to provide adequate personal hygiene, specifically fingernail and toenail care, for two residents during Activities of Daily Living (ADL) care. Observations revealed that both residents had long fingernails, with a black substance under each nail, extending significantly past the ends of their fingers. One resident also had toenails that were excessively long. Both residents expressed a desire to have their nails trimmed. The facility's policy included nail care as part of ADL care, and supplies for nail care were available in the unit. Record reviews showed that one resident had severe cognitive impairment with diagnoses of Chronic Obstructive Pulmonary Disease and Alzheimer's Disease, while the other had no cognitive impairment and diagnoses including paraplegia and muscle weakness. Interviews with nursing staff and the DON confirmed that nail care was the responsibility of licensed nursing staff and was included in routine care, with a system in place for podiatrist visits for toenail care. Despite these policies and available resources, the necessary nail care was not provided to the two residents.