Failure to Provide Routine Nail Care for Dependent Resident
Penalty
Summary
A deficiency was identified when a resident with severe cognitive impairment, a history of Marfan syndrome, dementia, and stroke, was not provided with routine nail care as required by facility policy. The resident's care plan specified that nail length should be checked and nails trimmed and cleaned on bath days and as necessary. Despite this, documentation and staff interviews revealed that the resident's nails had not been trimmed since a documented activity on 3/18/25, and on observation, the resident's fingernails were found to be clean but approximately 1/4 inch long. The resident required substantial to maximal assistance with activities of daily living, including bathing and nail care, due to their medical conditions and cognitive status. Further review showed that the resident was scheduled to receive a shower and associated care, including nail care, on a specific day, but the shower was not provided due to a missing key to the shower room. Documentation for that day did not indicate whether nail care was performed. Staff interviews confirmed that nail care should have been provided regardless of whether the shower occurred, and the DON verified that the last documented nail trimming was over a month prior. This failure to provide routine nail care as outlined in the care plan and facility policy constituted the deficiency.