Failure to Provide Necessary Nail Care for Dependent Residents
Penalty
Summary
The facility failed to provide necessary assistance with activities of daily living (ADLs) related to personal hygiene for two residents who were unable to perform these tasks independently. One resident with a history of stroke and moderately impaired cognition was observed on two consecutive days with long, jagged fingernails and a brown substance caked underneath them. This resident expressed a desire to have his nails cleaned, trimmed, and filed, stating it would make him feel better. The resident's care plan noted an ADL self-care performance deficit but did not include specific interventions for personal hygiene or nail care. Another resident, diagnosed with Parkinson's Disease and peripheral vascular disease and with severely impaired cognition, was also observed on two consecutive days with long, jagged fingernails in need of trimming and filing. This resident was dependent on staff for personal hygiene and expressed a wish to have his nails trimmed. Staff interviews revealed that CNAs were responsible for nail care for non-diabetic residents and that nail care was typically performed during showers. However, the staff were unsure why nail care had not been completed for these residents. Facility policy required daily cleaning and regular trimming of nails, but this was not followed for the two residents identified.