Failure to Provide Nail Care for Dependent Residents
Penalty
Summary
The facility failed to provide adequate nail care for dependent residents, as evidenced by record reviews, observations, and staff interviews. Three residents with significant cognitive and physical impairments, who were dependent on staff for activities of daily living (ADLs), were found to have long, dirty, or jagged fingernails and toenails. Documentation showed that nail care was not completed during multiple showers for these residents, and there were no refusals documented for some of the missed care. Observations confirmed the poor nail condition, including long nails with dark substances underneath and thick, jagged toenails. Staff interviews corroborated the findings, with CNAs acknowledging the residents' unkempt nails and stating that nail care should be performed after bathing or showering. The facility's policy required staff to provide care and services for ADLs, including grooming and personal hygiene, but this was not consistently followed for the affected residents. The deficiency was identified through a combination of medical record review, direct observation, and staff confirmation.