Failure to Provide Required Nail Care for Dependent Resident
Penalty
Summary
A resident with severe cognitive impairment, neurological disorder, contracture of the left arm, and vascular dementia was dependent on staff for all activities of daily living, including personal hygiene and nail care. The resident's care plan required staff to check, trim, and clean nails on bath days and as necessary, with no documented refusals of care. Despite this, multiple observations over several days revealed the resident's fingernails were long, jagged, and had a brown substance under one nail. The resident indicated a need for nail care, but there was no evidence that staff addressed this need. Interviews with direct care staff, including a nursing assistant, the DON, and a medication aide, confirmed that the resident's nails were in poor condition and that nail care was expected to be performed on shower days and as needed. Staff acknowledged they had not noticed or addressed the resident's nail care needs, and there were no documented refusals or reasons for the lack of care. The deficiency resulted from the facility's failure to provide necessary assistance with nail care for a resident who was fully dependent on staff.