Failure to Provide Adequate Nail Care for Dependent Residents
Penalty
Summary
The facility failed to provide necessary services for residents who were unable to carry out activities of daily living (ADLs), specifically in maintaining good grooming and personal hygiene. Two residents who required substantial assistance with personal hygiene and bathing were observed to have dirty, long, and jagged fingernails with black discoloration underneath. Both residents expressed a desire to have their nails cleaned and trimmed. Record reviews confirmed that both residents had care plans indicating the need for staff assistance with nail care as part of their ADL support. Interviews with staff, including a CNA, LVN, and the DON, revealed that responsibility for nail care was shared among CNAs and nurses, with nurses specifically responsible for residents with diabetes. Staff acknowledged that nail care was typically performed on shower days and as needed, but both residents' nails had not been maintained according to these expectations. The facility's policy required essential ADL services, including grooming and personal hygiene, to be provided to all residents.