Failure to Provide Nail Care for Dependent Residents
Penalty
Summary
Staff failed to provide necessary activities of daily living (ADL) assistance for two residents in the facility. One resident, diagnosed with Type 2 Diabetes Mellitus with Diabetic Polyneuropathy, was observed to have long toenails, with the great toe on the right foot curving and causing discomfort. The resident could not recall when her toenails were last trimmed. Interviews with staff revealed that nurses are responsible for trimming the nails of diabetic residents, and the Director of Nursing confirmed that diabetic residents should be referred to a podiatrist. However, there was no podiatry referral found in the resident's chart. Another resident, who required substantial to maximal assistance for ADL care, was observed to have long and unkempt fingernails. Staff confirmed that the resident's fingernails needed to be cut and stated that nail checks are typically performed on shower days. The Director of Nursing acknowledged that ADL care, including nail care, should be provided. These findings indicate that the facility did not ensure proper ADL assistance related to nail care for both residents.