Failure to Provide Timely Incontinence and Nail Care Assistance
Penalty
Summary
The facility failed to provide necessary assistance with activities of daily living (ADLs), specifically incontinence care and nail care, for several residents who were dependent on staff for these needs. One resident with hemiplegia, aphasia, and dementia was observed sitting in the dining room for nearly three hours without being checked or changed, despite care plans requiring staff to check and change incontinence briefs every two hours. When eventually attended to, the resident's brief, clothing, and mechanical lift sling were saturated with urine, and staff confirmed that care should have been provided sooner. Other residents with severe cognitive impairment, central cord syndrome, and dementia were observed with long, jagged fingernails containing black substances underneath. These residents required maximal or total assistance with personal hygiene and grooming, as documented in their care plans. Despite this, their fingernails remained untrimmed and unclean over consecutive days, and some residents verbally expressed their desire for staff to trim and clean their nails. Staff interviews confirmed that grooming, including nail care, was the responsibility of the CNAs and should be performed as needed. The facility's own ADL policy required staff to provide appropriate care and services to maintain residents' hygiene and grooming, including nail care and toileting, for those unable to perform these tasks independently. Observations and interviews demonstrated that staff did not consistently follow these policies, resulting in residents not receiving timely incontinence care or adequate assistance with nail hygiene.