Failure to Provide Required Nail Care for Dependent Resident
Penalty
Summary
The facility failed to provide appropriate nail care for a resident who required assistance with activities of daily living (ADLs) due to hemiplegia and hemiparesis following a cerebrovascular event, as well as other medical conditions including type 2 diabetes mellitus and chronic kidney disease. Facility policy required daily personal hygiene, including nail care, and specified that nails should be kept neatly trimmed. The resident's care plan also directed staff to keep fingernails trimmed and clean. Despite these requirements, observations on multiple occasions revealed that the resident's fingernails on the hemiparetic hand were long and extended past the fingertips. The resident reported wanting their nails trimmed and stated that only a nurse could perform this task due to their diabetes diagnosis. Interviews with staff confirmed that certified nurse aides were responsible for cleaning nails during ADL care, but only nurses were permitted to trim nails for diabetic residents. Both the RN and DON acknowledged that the resident's fingernails should have been trimmed and should not extend past the fingertips, in accordance with facility policy and expectations. The administrator also confirmed that nails should be kept clean and trimmed to the resident's preference. Despite these expectations and policies, the resident did not receive the required nail care, resulting in a deficiency.