Failure to Provide Foot and Nail Care for Dependent Resident
Penalty
Summary
The facility failed to provide appropriate foot care and nail care for one resident who was totally dependent on staff for ADLs, resulting in overgrown, yellow, thick, and cracked toenails. The resident had been admitted on an unspecified date and had a documented history of painful mycotic toenails, with a progress note directing removal of all affected mycotic nail tissue to the exposed nail beds as tolerated. During observations, the resident reported that his toenails had not been cut in a long time, and surveyors noted the overgrown condition of the toenails. Review of the medical record showed no documentation that staff had provided toenail care, and the DON confirmed that the resident’s toenails were overgrown, had not been cut, and that there was no documentation of toenail care being provided. The DON further confirmed during observation that the resident’s fingernails were also overgrown and had not been cut, reinforcing that nail care had not been performed or documented. The lack of documented toenail care, despite the resident’s dependence on staff and the existing order to remove mycotic nail tissue, demonstrates that staff did not carry out or record necessary foot and nail care for this resident.
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