F0677

D

Failure to Provide Adequate Nail Care for Dependent Resident

Chardon, Ohio Survey Completed on 02-26-2026

Penalty

No penalty information released

Summary

The deficiency involves the facility’s failure to provide adequate nail care as part of activities of daily living (ADL) assistance for a dependent resident. The resident was admitted with multiple significant diagnoses, including severe protein-calorie malnutrition, basal cell carcinoma of the scalp and neck, secondary malignant neoplasm of the bone, convulsions, type 2 diabetes mellitus, anxiety disorder, and absence of the right eye. Her MDS showed intact cognition with a BIMS score of 14, but she required maximum assistance with upper body dressing and was dependent on staff for lower body dressing, toileting, showering, personal hygiene, and mobility. Her care plan identified an ADL self-care, mobility, and functional performance deficit related to cancer, diabetes, and seizures, and documented that she was dependent on staff for personal hygiene tasks.

During an interview and observation, surveyors noted that the resident’s fingernails were long and dirty. The resident reported that staff only cleaned and trimmed her fingernails when she specifically asked and that she was unsure when they were last cleaned; she also stated that nail care was not included as part of her routine bathing or hygiene. A subsequent observation again found long and dirty fingernails, which was confirmed by both the resident and a CNA. The CNA stated that fingernails were cleaned on shower days but that this resident received only bed baths, and the CNA was unsure when the resident last had a bed bath or when her nails were last cleaned. The facility’s ADL Care policy, reviewed on 01/06/25, stated that staff were expected to assist dependent residents with maintenance of personal hygiene, including nail care, indicating that this expected care was not being consistently provided.