Failure to Provide Appropriate Foot Care
Penalty
Summary
The facility failed to provide appropriate foot care for a resident who requires total assistance with personal care. The resident, who is non-verbal and has severe cognitive impairment due to Alzheimer's disease, was observed with overgrown toenails and very dry skin on the feet. The toenails were noted to be growing sideways, with the left big toenail slightly misaligned and separated from the nail matrix, creating a gap with an unknown black substance. The right big toenail was also sticking sideways and measured 1.8 cm in length. The nurse (LPN) acknowledged that the facility's CNAs or hospice CNA staff should notify nurses when a podiatry consult is needed for toenail clipping. However, the nurse was unable to confirm when the resident was last seen by a podiatrist. The Director of Nursing stated that toenails should be assessed by staff and referred for podiatry consult if needed, with consent obtained from the resident or family member. The facility's policy on nail care emphasizes daily cleaning and regular trimming to prevent infections and skin problems, which was not adhered to in this case.