Failure to Provide Hand and Nail Hygiene for Dependent Resident
Penalty
Summary
The facility failed to provide appropriate hand and nail hygiene for a dependent resident who required staff assistance with personal care. Medical record review showed the resident had moderately impaired cognition and required help with bathing and personal hygiene. During observation, the resident was found to have fingernails that were too long and had debris underneath, which interfered with his ability to use his communication device. The resident confirmed that staff had not offered to cut his nails, and the length of his nails made it difficult for him to use his iPad for communication. Interviews with facility staff, including the DON, ADON, and an LPN, confirmed that nail care was expected to be performed during scheduled showers, which were offered at least twice weekly, but there was no set schedule for hand or nail care outside of these times. The facility policy required daily cleaning and regular trimming of nails, but this was not consistently implemented. Staff also confirmed that documentation of nail care or refusals was expected but not always completed. This resulted in the resident not receiving necessary nail care as required by facility policy.