Failure to Provide Necessary Fingernail Care for Dependent Resident
Penalty
Summary
A resident with severe cognitive impairment and multiple diagnoses, including non-Alzheimer's dementia, cerebrovascular accident, hypertension, and muscle weakness, was identified as requiring assistance with activities of daily living (ADLs), including personal and oral hygiene. The resident's care plan specified the need for setup or clean-up assistance with oral hygiene and partial/moderate assistance with personal hygiene. During observation, the resident was found in bed with fingernails approximately 0.3 cm long and visibly dirty, containing a brown substance underneath. The resident expressed a preference for long nails but indicated a desire for them to be cleaned. Interviews with staff, including the CSD and the Administrator, confirmed that it was the responsibility of care staff to ensure residents' fingernails were cleaned and trimmed according to their preferences, with nurses responsible for trimming the nails of diabetic residents. The facility's policy required daily cleaning and regular trimming of nails to prevent infections and skin problems. Despite these policies and care plan interventions, the resident did not receive the necessary fingernail care, as evidenced by the observed condition of the nails and staff acknowledgment that care was needed.