Failure to Provide Necessary Nail Care for Dependent Resident
Penalty
Summary
A deficiency occurred when a resident who was dependent on staff for personal hygiene did not receive necessary nail care. The resident, who had diagnoses including dementia, Alzheimer's disease, anemia, and hypertension, was rarely or never understood and required total assistance for personal hygiene according to her care plan. Observations on multiple occasions over two days revealed that the resident's fingernails had a dark, brown substance underneath them, indicating they had not been cleaned. Staff interviews confirmed that nail care was expected to be performed during bed baths and daily care, but the resident's nails remained unclean during the observed period. The facility's policy required routine cleaning and inspection of nails during ADL care, but this was not followed for the resident in question. Staff acknowledged responsibility for nail care and noted that the resident sometimes resisted, but there was no care plan indicating resistance to nail care. The issue was identified through observation, interview, and record review, confirming that the resident did not receive the necessary services to maintain personal hygiene as required.