Failure to Provide ADL Nail Care to Dependent Resident
Penalty
Summary
The facility failed to provide adequate Activities of Daily Living (ADL) care to a dependent resident, as evidenced by multiple observations and interviews. The resident, who has a significant ADL self-care performance deficit due to a complex medical history including progressive vascular leukoencephalopathy, multiple sclerosis, dementia, depression, arthritis, and other conditions, was found to have long and jagged fingernails on both hands. The resident's care plan indicated total dependence on staff for personal hygiene, including nail care, with staff responsible for performing all related tasks. During a family interview, the Medical Power of Attorney reported that the resident's fingernails were consistently untrimmed during visits, sometimes causing indentations in the resident's hands. This observation was confirmed by a surveyor and acknowledged by an LPN, who agreed that the resident's fingernails needed to be cut. Record review further supported that the resident required full assistance with ADLs, yet the necessary nail care was not provided as required by the care plan.