Skip to main content

✨ Assisted Living & Skilled Nursing

toenail trimming in ALF and memory care
Author Last Post

This simple grooming task is not as simple as it seems. State and federal regulations mandate how this is to be done and by whom. Depending on the state, different trained professionals are allowed to trim nails. Some medical conditions, such as diabetes, can be markedly worsened by going his incorrectly as some people are susceptible to infections. Needless to say, that is a risk management issue for any facility. The procedure seems simple, but it is not. Here is an AI generated run down of the main topics. Best to ask the nursing supervisor how this is done in your state and facility. Hope this helps.


AI Overview

Learn more


In most nursing homes, regulations state that only trained staff, typically nurses or certified nursing assistants (CNAs) with specific training, can trim toenails, and residents with conditions like diabetes or poor circulation should always be referred to a podiatrist for toenail care due to the heightened risk of complications; this includes proper documentation of any nail trimming procedures and immediate reporting of any issues like cuts or infections. 

Key points about toenail trimming in nursing homes:

  • Qualified personnel:
  • Only staff trained in proper foot care techniques should trim toenails, and in many cases, this means referring diabetic or high-risk residents to a podiatrist. 
  • Physician orders:
  • A doctor's order is often required before any toenail trimming, especially for residents with specific medical conditions. 
  • Assessment of needs:
  • Staff should assess each resident's foot health to identify potential problems like ingrown toenails, calluses, or poor circulation before performing any nail care. 
  • Documentation:
  • All toenail trimming procedures should be documented in the resident's medical record, including details like date, time, who performed the procedure, and any observations made. 
  • Infection control:
  • Strict hygiene practices must be followed during toenail trimming to prevent infections. 

Potential complications of improper toenail trimming:

  • Cuts and injuries:
  • Improper technique could lead to cuts in the skin, increasing the risk of infection. 
  • Ingrown toenails:
  • Incorrect trimming can contribute to ingrown toenails, causing pain and inflammation. 
  • Aggravated circulation issues:
  • For individuals with poor circulation, improper nail care can worsen existing problems. 


Outside service of nail techs for which appointments have to be made and paid for as well as podiatrist who comes every six weeks or so for those who qualify for Medicare coverage.

I live at Covenant Woods, Richmond, VA. We have a podiatrist who is an outside vendor. She treats IL and AL residents.

For Independent Living, our CCRC has a podiatrist on staff. I believe no one else trims toenails. Not sure about AL and Memory and LTC

What is your organization's policy on trimming residents' toenails? Only RN? Outside podiatrist? LPN? Any training provided if healthcare staff do it?

Thank you.

Return to Forum