Failure to Provide Nail and Personal Hygiene Care for Dependent Residents
Penalty
Summary
The deficiency involves the facility’s failure to maintain personal care and hygiene, specifically nail care, for dependent residents who required staff assistance with activities of daily living (ADLs). Facility policy stated that appropriate care and services were to be provided for residents unable to carry out ADLs independently, including hygiene such as grooming and personal care. Resident R68’s quarterly MDS dated December 10, 2025, showed impairment in range of motion in both upper and lower extremities, moderate cognitive impairment, and diagnoses including CVA, right-sided hemiplegia, and malnutrition. The comprehensive care plan dated October 25, 2024, identified an ADL self-care performance deficit and dependence on staff for grooming/personal hygiene, with an intervention dated December 4, 2025, directing staff to check nail length and clean on bath day and as necessary. On January 7, 2026, at 10:15 a.m., observation revealed a right-hand contracture with the hand naturally in a fist and fingernails that were long and folding into the palm; the resident confirmed wanting the nails trimmed. Resident R10’s comprehensive MDS indicated impairment in range of motion in upper and lower extremities and dependence on staff for personal hygiene, along with severe cognitive impairment and diagnoses of arthritis, aphasia, CVA, and hemiplegia or hemiparesis. The comprehensive care plan dated May 14, 2021, documented an ADL self-care performance deficit and the need for assistance with grooming/personal hygiene, with an intervention dated November 5, 2021, to check nail length and clean on bath day and as necessary. On January 8, 2026, at 12:15 p.m., observation showed a right-hand contracture with the hand naturally in a fist. With assistance from Licensed Nurse Employee E11, the resident’s right hand was opened, revealing long, thick nails with dirt beneath them; the nurse confirmed that the nails required care. These findings demonstrated that staff did not follow the care-planned interventions and policy requirements to monitor and maintain nail hygiene for these dependent residents.
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