Failure to Assess and Maintain Resident's Fingernail Hygiene
Penalty
Summary
The facility failed to ensure that a resident's fingernails were properly assessed and treated in a timely manner, as required by the resident's care plan and facility policy. The resident, who was admitted with end stage renal disease, a right humerus fracture, and lack of coordination, was dependent on staff for personal hygiene and other activities of daily living. The care plan specified that staff should check, trim, and clean the resident's nails on bath days and report any changes to the nurse. However, weekly skin assessments did not address the resident's fingernails, and observations revealed that the resident's fingernails were yellowed, thickened, and had debris underneath. Interviews with the resident and staff confirmed that the fingernails had not been addressed or noticed during routine care and wound assessments. The LPN Unit Manager and Wound Nurse both acknowledged the condition of the resident's fingernails when it was brought to their attention, and the Wound Nurse confirmed she had not previously noticed the issue during weekly assessments. The facility's policy on nail care emphasized the importance of cleaning, trimming, and monitoring for changes, but these procedures were not followed for this resident.