Failure to Provide Nail Care for Dependent Resident
Penalty
Summary
Facility staff failed to provide necessary activities of daily living (ADL) care, specifically nail care, to a dependent resident diagnosed with idiopathic peripheral autonomic neuropathy, type 2 diabetes mellitus, and muscle weakness. The resident was assessed as moderately cognitively impaired and required assistance with ADLs according to their care plan. During multiple interviews, the resident reported that their long, jagged fingernails with brownish debris underneath were bothersome and stated that they had asked staff to trim their nails but this was not done. The resident indicated they resorted to chewing their nails due to lack of assistance. Observations confirmed the resident's nails were untrimmed, and staff interviews revealed inconsistencies regarding who was responsible for providing nail care and the frequency with which it was performed. While CNAs and nurses were identified as responsible for nail care, staff who worked with the resident that week had not provided the service. Facility policy required nursing staff to provide care according to current standards, but documentation and interviews indicated this standard was not met for the resident in question.