Failure to Provide Adequate Nail Care for Dependent Resident
Penalty
Summary
The facility failed to provide necessary services for a resident who was unable to perform activities of daily living (ADLs), specifically in maintaining good grooming and personal hygiene. The resident, an elderly male with severe cognitive impairment and multiple medical diagnoses including dehydration, coronary artery disease, and benign prostatic hyperplasia, required maximum assistance with personal hygiene according to his care plan. Despite this, observations on the specified date revealed that the resident's fingernails were overgrown, discolored, and had brown matter underneath. The resident expressed a desire to have his fingernails trimmed and cleaned. Record review showed that his last bed bath was two days prior and his last shower was several days before the observation. Interviews with staff, including a CNA, LVN, and the ADON, confirmed that both CNAs and nurses were responsible for nail care, with nurses specifically handling nail care for diabetic residents. Staff acknowledged that nail care should be performed on shower days and as needed, and that dirty, long nails could pose an infection risk. The facility's policy required regular nail management to promote cleanliness and prevent infection, typically during bathing. However, the resident's nail care needs were not met as required by his care plan and facility policy.