Failure to Provide Required Nail Care for Dependent Resident
Penalty
Summary
A deficiency was identified when a resident with hemiplegia, hemiparesis, severe cognitive impairment, and a history of stroke was not provided with necessary assistance for activities of daily living (ADLs), specifically in maintaining proper grooming and nail care. The resident's care plan and facility policy required that fingernails be kept short and clean, with nail trimming to occur on bath or shower days and as needed. Despite these documented interventions, the resident was repeatedly observed by surveyors to have extremely long and dirty fingernails on all fingers of both hands over multiple days during the survey process. The resident's medical record indicated a need for partial to moderate assistance with hygiene and personal care due to significant physical and cognitive limitations. The care plan and Kardex both instructed staff to keep the resident's fingernails short to avoid scratching and protect skin integrity. However, observations made by the surveyor on several occasions showed that this care was not provided, and facility leadership was unable to provide an explanation for the failure to perform the required ADL assistance. No additional information was provided by the facility regarding why the resident's nail care was neglected.