Failure to Provide Appropriate Foot Care for Dependent Resident
Penalty
Summary
A resident who was dependent on staff for personal hygiene and was receiving hospice care was repeatedly observed with very long toenails over several days. The resident, who had diagnoses including acute respiratory failure, anxiety, heart disease, osteoarthritis, and heart failure, was severely impaired for decision making and was never or rarely understood, according to the Minimum Data Set assessment. Despite being under hospice care, there was no documentation of podiatrist visits since admission, and hospice had previously determined that podiatry services were not necessary for this resident. Staff, including a QMA and the Wound Nurse, were made aware of the resident's long toenails, and the Director of Nursing confirmed that hospice staff provided regular care, during which the toenails should have been observed.