Failure to Provide Required Nail Care Assistance
Penalty
Summary
The facility failed to provide necessary assistance with nail care for one resident who was unable to perform this activity independently. The resident, who had diagnoses including bipolar disorder, heart failure, muscle weakness, and required assistance with personal care, was observed on multiple occasions to have long and jagged fingernails with sharp edges. The resident expressed a desire to have his fingernails trimmed short, specifically mentioning his interest in playing the guitar. Despite this, observations on consecutive days confirmed that the resident's fingernails remained untrimmed. Documentation on the resident's Shower Check Skin Observations sheets also indicated that nail clipping was needed, and these sheets were signed by both a CNA and a licensed nurse. Interviews with staff, including a CNA, the Director of Staff Development (DSD), and the Director of Nursing (DON), confirmed that nail care should be performed at least twice a week on shower days and as needed, and that the resident's current nail condition was not acceptable. The facility's policy required that residents unable to perform ADLs independently receive appropriate support and assistance with hygiene and grooming, including nail care. However, the necessary care was not provided, as evidenced by the resident's continued long and jagged fingernails despite documented need and staff awareness.