Failure to Provide Nail Care and Shaving for Dependent Resident
Penalty
Summary
A deficiency was identified when a resident with a history of stroke and diabetes, who was severely cognitively impaired and dependent on staff for all activities of daily living (ADLs), was not provided with adequate nail care or facial shaving. Observations over several days revealed that the resident had a full, dense beard approximately 1/2 inch in length and fingernails extending more than 1/4 inch past the fingertips. Nursing assistants assigned to the resident reported that they checked nails during baths but had not noticed the long nails or provided shaving. Both nursing assistants interviewed stated they had not clipped the resident's nails or shaved his facial hair, nor had they consulted the resident's family regarding his grooming preferences. The resident's representative reported repeated requests for nail trimming and shaving, stating that the resident had previously been clean-shaven or had a closely clipped beard prior to his stroke and would not have wanted long nails or facial hair. Nursing and administrative staff confirmed that nail care and shaving should be performed as needed and during baths, but were unaware of the resident's current condition or the representative's requests. The lack of attention to the resident's grooming needs resulted in the resident not maintaining a clean, neat, and odor-free appearance as outlined in his care plan.