Failure to Provide Timely Podiatry Care for Diabetic Resident
Penalty
Summary
A resident with diagnoses including type II diabetes mellitus, lymphedema, and peripheral vascular disease was admitted to the facility and had a care plan intervention for referral to a podiatrist or foot care nurse to monitor and document foot care needs, including cutting long nails. The resident was cognitively intact and required substantial to maximal assistance with personal hygiene. During an observation, the resident was found in bed with toenails that were jagged, pointed, and varied in length, with some measuring up to one inch. The resident reported pain from her long toenails, which prevented her from covering her feet with a sheet, and stated she had missed the most recent podiatry clinic due to hospitalization. She was unsure when she would next be seen by the podiatrist, despite having communicated her concerns to nursing staff. Review of the podiatry schedule confirmed the resident had not been seen at the last clinic due to hospitalization and was scheduled for the next clinic several weeks later. Staff interviews revealed that the resident's complaints about painful toenails were reported to a nurse, but the nurse was unaware of the pain and had not observed the toenails' condition. The DON was also unaware of the resident's pain following the missed clinic. The facility failed to provide timely podiatry care or alternative arrangements for foot care after the resident missed the scheduled clinic, resulting in prolonged discomfort and unaddressed foot care needs.