Failure to Provide Adequate Nail Care for Dependent Residents
Penalty
Summary
The facility failed to provide necessary assistance with activities of daily living (ADLs), specifically nail care, for two residents who were unable to perform these tasks independently. Both residents required staff support for personal hygiene, grooming, and other ADLs as documented in their care plans and assessments. Despite this, observations revealed that both residents had blackish/brownish substances under their fingernails and uneven nail edges, indicating that nail care had not been performed as required. Interviews with the residents confirmed that they had requested nail care assistance from staff, but their requests were not fulfilled. Staff interviews revealed that certified nursing assistants (CNAs) were responsible for nail care for most residents, while nurses handled nail care for residents with diabetes. Staff members acknowledged being in-serviced on nail care but could not recall when, and none reported that the residents had refused care. Documentation did not indicate any refusals, and staff were unable to specify when the last nail care was provided to these residents. The facility's policy required that residents unable to perform ADLs independently receive necessary services to maintain good grooming and hygiene. However, the lack of timely and adequate nail care for these two residents, as observed and confirmed through interviews and record reviews, demonstrated a failure to follow this policy and to meet the residents' assessed needs for assistance with personal hygiene.