Resident 80 had long fingernails with a dark substance under the left-hand nails when inspectors arrived. The finding prompted questions about basic grooming care at the 1300 Hill Road North facility.
CNA 161 told inspectors that if she observed long, dirty fingernails, she would clean and cut them. But the evidence suggested this wasn't happening consistently.
The second case involved Resident 77, whose medical complexity made the nail neglect more concerning. He had been admitted with acute respiratory failure and required a tracheostomy to breathe. His diagnoses included diabetes, psoriasis, obstructive hydrocephalus, high blood pressure and a gastrostomy feeding tube.
Resident 77 was completely dependent on staff for everything. His quarterly assessment showed he was rarely or never understood when he tried to communicate. Staff had to handle all his oral hygiene, toileting, bathing, dressing and personal care. He was always incontinent of both bowel and bladder and couldn't turn or reposition himself.
Despite this total dependence on staff care, inspectors found his fingernails and toenails severely neglected.
On September 22 at 2:41 p.m., inspectors documented that Resident 77's fingernails and toenails were long and jagged. The next day at 1:58 p.m., he remained in bed with fingernails and toenails that were still long, thick and jagged.
By 3:30 p.m. on September 23, nothing had changed. His fingernails and toenails remained thick, long and jagged. Registered Nurse 194 was present during the inspection and verified what inspectors were seeing.
The facility's own policy, dated January 1, 2025, states that care and services will be provided for activities of daily living including bathing, dressing, grooming and oral care. Nail care falls squarely within grooming requirements.
For Resident 77, the nail neglect represented a basic failure in his comprehensive care plan. As someone who couldn't speak clearly, couldn't move independently, and relied entirely on staff for hygiene, overgrown nails could cause additional complications. Long, jagged nails can scratch skin, harbor bacteria, and make basic care tasks more difficult.
The inspection revealed a pattern rather than isolated incidents. Two different residents, with different care needs, both had the same problem with nail maintenance.
Federal regulators cited the facility under tag F677, which covers residents' rights to personal cleanliness and grooming. The violation was classified as causing minimal harm or potential for actual harm, affecting few residents.
But for residents like 77, who depend completely on staff for every aspect of personal care, there is no backup system when facility grooming protocols fail. His inability to communicate clearly means he couldn't advocate for basic nail care himself.
The thick, jagged condition of his nails suggested the neglect had been ongoing for weeks. Fingernails typically grow about 3 millimeters per month, so the length documented by inspectors indicated sustained inattention to this basic hygiene need.
Resident 80's case, with dark substance under the fingernails, raised additional concerns about cleanliness standards. The buildup suggested not just overgrown nails but inadequate cleaning of existing nail length.
The facility operates under federal requirements that residents receive care and services to attain or maintain their highest practicable physical, mental and psychosocial well-being. Basic grooming, including nail care, is fundamental to dignity and health maintenance.
When CNA 161 told inspectors she would address long, dirty nails if observed, it suggested the facility had appropriate knowledge of what to do. The problem appeared to be consistent observation and follow-through rather than lack of training.
For families of residents requiring total care, the nail neglect raises questions about what other basic hygiene needs might be overlooked. If something as visible as severely overgrown fingernails goes unaddressed for weeks, it suggests gaps in daily care routines.
The inspection occurred on November 17, 2025, as part of a complaint investigation. The specific nature of the complaint that triggered the inspection was not detailed in the available report, but inspectors documented the nail care deficiencies during their visit.
Resident 77 remained in bed during both days of inspection observations, his thick, jagged nails unchanged from one day to the next while inspectors watched and documented the ongoing neglect.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Pickerington Care and Rehabilitation from 2025-11-17 including all violations, facility responses, and corrective action plans.
Additional Resources
- View all inspection reports for Pickerington Care and Rehabilitation
- Browse all OH nursing home inspections