Failure to Provide Necessary Assistance with Personal Hygiene
Penalty
Summary
Facility staff failed to provide necessary assistance with personal hygiene for a resident who was unable to perform activities of daily living independently. The resident, who had a history of stroke, diabetes, hypertension, and a contracted right hand with curled fingers, was assessed as dependent in upper and lower body dressing, footwear, and personal hygiene. During an interview, the resident reported pain in his right hand due to long fingernails and could not recall the last time staff had trimmed them. Observation confirmed the presence of long, rammed fingernails, dry skin, and healed scars on the resident's right hand. The resident also reported removing his splint due to discomfort. Review of the care plan indicated interventions for pain management and contracture care, but there was no documentation of the resident refusing fingernail care or of staff providing education regarding this aspect of hygiene. The Unit Manager acknowledged that the resident was care planned as non-compliant with fingernail care but could not provide evidence of refusals or education attempts. The lack of documentation and failure to maintain the resident's fingernail hygiene led to the deficiency cited by surveyors.