Failure to Provide Routine Fingernail Care and Shaving per Resident Preference
Penalty
Summary
A deficiency was identified when a dependent resident with non-Alzheimer's dementia and bilateral hand contractures did not receive routine fingernail care and was not shaved according to his stated preference. The resident was totally dependent on staff for bathing and personal hygiene, as documented in his care plan and most recent MDS assessment. Observations revealed that the resident's fingernails were approximately 1/2 inch long, discolored, and had a dark substance underneath. The resident also had facial hair about 1/2 inch long, despite expressing a preference to be clean shaven. The resident did not exhibit behaviors or reject care. Interviews with staff indicated confusion regarding responsibility for fingernail care and shaving. The activities staff member, prompted by a family request, ultimately trimmed the resident's fingernails, describing them as very long and dirty. The nurse aide assigned to the resident was unsure if she was permitted to trim fingernails and believed shaving male residents was the responsibility of the facility's Scheduler, who only shaved residents when cutting their hair. The Administrator confirmed that staff were expected to provide grooming care according to resident preferences, including fingernail care and shaving, typically on bath days and as needed.