Failure to Provide Required Nail Care for Dependent Residents
Penalty
Summary
The facility failed to provide necessary nail care for four out of ten residents who were unable to perform this activity of daily living themselves. According to the facility's policy, nail care should include daily cleaning and regular trimming. Observations and interviews revealed that several residents had long fingernails, some with brown debris underneath, and expressed that their nails had not been cut or cleaned by staff. One resident's representative reported having to cut the resident's nails themselves due to lack of care from facility staff. These findings were confirmed during walking rounds with the Assistant Director of Nursing, who acknowledged the deficiency. The affected residents had significant medical conditions, including stroke with hemiplegia, high blood pressure, difficulty swallowing, malnutrition, muscle weakness, dementia, low back pain, Parkinson's disease, and hip fracture. Despite these conditions, which limited their ability to perform self-care, the facility did not ensure that nail care was provided as required by policy. The deficiency was identified through review of records, direct observation, and interviews with both residents and staff.