F0677

D

Failure to Provide Nail Care for Dependent Residents

Columbus, Ohio Survey Completed on 03-23-2026

Penalty

No penalty information released

Summary

The facility failed to provide adequate nail care for two residents who were dependent on staff for activities of daily living. One resident, admitted with multiple diagnoses including COPD, dysphagia following cerebral infarction, malnutrition, hypertension, anxiety, and depression, was cognitively intact and dependent on staff for putting on and taking off footwear. Observation showed this resident had long, jagged toenails, and the resident reported that staff did not provide toenail care. A CNA confirmed the poor condition of the toenails and expressed uncertainty about whether CNAs were permitted to trim toenails. The resident had previously declined podiatry care, and facility documents indicated that CNAs were responsible for personal care and that routine daily care was to be provided.

The second resident had an admission diagnosis that included anoxic brain damage, COPD, dysphagia, bilateral hand contractures, ADHD, moderate protein-calorie malnutrition, psychoactive substance abuse, anxiety disorder, and cognitive communication deficit, with severely impaired cognition and dependence on staff for personal hygiene and bathing. The care plan identified self-care deficits related to anoxic brain injury and contractures, and noted the resident was dependent for personal hygiene. There was no documentation in the medical record indicating when this resident’s nails were cleaned or cut. Observations on multiple occasions revealed long fingernails on both hands, with a dark brown substance underneath, and the resident declined to open his contracted hand or accept assistance. Staff interviews showed confusion about responsibility for nail care, with a CNA and an RN suggesting an outside service or hospice might be responsible, while the DON stated that CNAs were responsible for nail care.