Failure to Provide Nail Care for Cognitively Impaired Resident
Penalty
Summary
Staff failed to provide adequate nail care for a resident who was severely cognitively impaired and required partial to moderate assistance with personal hygiene. The resident was admitted with diagnoses including major depression and had a Brief Interview for Mental Status (BIMS) score of five out of 15, indicating severe cognitive impairment. Documentation in the electronic medical record showed that the resident received varying levels of assistance with personal hygiene, and there was no documentation of refusal of care during the period reviewed. Despite this, observations on multiple occasions revealed that the resident's fingernails were long, jagged, and had a brown substance underneath. The care plan for the resident addressed general refusals of care but did not specifically address personal hygiene or nail care. Interviews with facility staff confirmed that the care plan was not specific to nail care, and staff were notified of the resident's nail condition. The lack of specific interventions and failure to provide necessary nail care resulted in the resident having dirty, untrimmed, and unclean nails over an extended period.