Failure to Provide Adequate Nail Care for Dependent Resident
Penalty
Summary
A deficiency was identified when a resident who required partial to moderate assistance with personal hygiene was observed to have fingernails that were approximately 0.5 cm in length, chipped, discolored, and with dark brown residue underneath. The resident expressed a desire to have his fingernails trimmed and cleaned. Record review indicated the resident had a history of lack of coordination, unsteadiness, muscle weakness, and moderately impaired cognition. The care plan specified that the resident needed extensive assistance with personal hygiene, including nail care. Interviews with staff revealed that both CNAs and nurses were responsible for ensuring residents' fingernails were cleaned and trimmed, with CNAs permitted to trim nails for non-diabetic residents. Staff acknowledged that the resident's nails needed attention and confirmed that nail care should be performed as needed and observed daily. Facility policy also required nail care to maintain cleanliness and proper trimming. Despite these protocols, the resident's fingernails were not maintained, resulting in a failure to provide necessary services for activities of daily living.