Failure to Provide Podiatry Services and Foot Care
Penalty
Summary
The facility failed to provide appropriate foot care and ensure podiatry services for two residents with significant medical histories, including diabetes and end stage renal disease. In both cases, signed consents for podiatry services were present in the residents' records, but there was no evidence that either resident had been seen by a podiatrist during their stay. For one resident, family-provided photos and interviews confirmed that the resident's toenails were long, thick, brittle, and had buildup underneath, with dry, scaly skin present on both feet. The family reported that no foot or nail care had been performed since admission, despite the resident's enjoyment of such care prior to entering the facility. The Director of Nursing confirmed the lack of podiatry visits and noted that the facility was unaware that a physician's signature was required on the consent forms, partly due to the abrupt departure of the social services designee. In the second case, the resident's husband had requested podiatry services due to complaints of discomfort from long toenails, and was told the resident was on the list to be seen. However, the resident was not seen by the podiatrist, and subsequent review revealed that the necessary physician order had not been signed. The Director of Nursing again confirmed the absence of podiatry care and attributed the oversight to a lack of awareness regarding the need for a physician's signature and the recent loss of the social worker designee. Both cases were substantiated by medical record reviews, family interviews, and photographic evidence.