Failure to Provide Adequate Nail Care for Dependent Residents
Penalty
Summary
The facility failed to provide adequate nail care for dependent residents, as evidenced by observations and interviews involving two residents with self-care deficits. One resident with dementia, Alzheimer's disease, and behavioral issues, including playing in her own feces, was observed on multiple occasions with dirty fingernails containing a dark brown substance. Despite care plan interventions specifying that nail length should be checked, trimmed, and cleaned on bath days and as necessary, the resident's nails remained soiled over several days, even while eating meals with her hands. Staff interviews confirmed the resident's behaviors and the ongoing issue with dirty nails. Another resident with multiple chronic conditions, including bipolar disorder and diabetes, was found to have long fingernails on repeated observations, although the nails were clean and not jagged. The resident expressed dissatisfaction with the length of his nails and requested they be trimmed, but staff were unaware of who was responsible for this task. The facility's policy required staff to follow the ADL care plan, which included nail care, but this was not consistently implemented for the residents reviewed.