Failure to Provide Necessary Nail Care for Dependent Resident
Penalty
Summary
A deficiency was identified when a resident who required maximal assistance with bathing and had a self-care deficit was observed to have long, discolored fingernails with brownish residue underneath. The resident, who had a history of cerebrovascular accident and elevated blood pressure, expressed dissatisfaction with the condition of his nails but did not inform staff because they appeared busy. The resident's care plan included assistance with grooming and hygiene, but on the day of observation, his fingernails had not been cleaned or trimmed. Interviews with staff revealed that both CNAs and nurses were responsible for nail care, but the assigned nurse had not noticed the resident's nails and acknowledged the risk of infection and injury. The DON stated that nail care should be performed as needed and during handwashing, with daily observation of nail condition. The facility's policy on ADLs and bathing did not address fingernail care, contributing to the failure to provide necessary services for maintaining the resident's personal hygiene.