Failure to Provide and Document Fingernail Care for a Dependent Resident
Penalty
Summary
Facility staff failed to provide necessary ADL assistance, specifically fingernail care, to a resident who was totally dependent on staff for ADLs. The resident’s admission record showed he had been admitted to the facility, and his annual MDS documented that he was totally dependent on staff to complete ADL care. During an observation and interview, the resident’s fingernails were noted to be overgrown, yellow, thick, and cracked, and the resident reported that his fingernails had not been cut in a long time. The DON and Unit Manager both confirmed that the resident’s fingernails were overgrown, thick, and in need of medical care, and the Unit Manager stated that the condition would require referral to an outside provider. Review of the resident’s medical record showed no documentation that fingernail care had been provided, and the DON confirmed that staff had not documented any fingernail care despite the resident’s total dependence on staff for ADLs. This failure to provide and document fingernail care for a totally dependent resident constituted a deficiency in ADL assistance that was likely to affect the dignity and health of the resident.
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