Failure to Provide Adequate Fingernail Hygiene for Dependent Resident
Penalty
Summary
The facility failed to ensure a resident who required assistance with activities of daily living received necessary services to maintain good personal hygiene, specifically related to fingernail care. The resident, admitted with multiple diagnoses including type 2 diabetes mellitus without complication, a stage 2 sacral pressure ulcer, COPD, need for assistance with personal care, lack of coordination, muscle wasting and atrophy of the right shoulder, major depressive disorder, generalized anxiety disorder, peripheral vascular disease, hypertensive heart disease with heart failure, personal history of venous thrombosis and embolism, obstructive sleep apnea, and obesity, had a physician order indicating the need for one-person assistance with ADLs. Observations on two consecutive mornings showed the resident’s fingernails were long with a dark brown grimy substance under the nails on both hands. During a subsequent observation with the DON present, the same condition of long, dirty fingernails was noted, and the DON confirmed the nails needed to be cleaned and trimmed. This deficiency centers on the facility’s failure to provide timely nail care and hygiene for a dependent resident, despite clear orders indicating the need for assistance with ADLs and repeated observable evidence of unclean, overgrown fingernails.
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