Failure to Provide Podiatry Services for Dependent Diabetic Resident
Penalty
Summary
A deficiency was identified when a resident with multiple diagnoses, including Type 2 Diabetes Mellitus and moderate cognitive impairment, did not receive appropriate foot care services. The resident was totally dependent on staff for personal hygiene and had signed a consent form for podiatry services. Despite this, there was no documentation in the medical record indicating that the resident had ever been seen by a podiatrist. During an observation, the resident's toenails were found to be long, jagged, and yellow, and the resident reported not having their toenails cut or being seen by a podiatrist. Facility policy required that residents with conditions such as diabetes receive toenail care from a physician or practitioner. Staff interviews revealed that the process for identifying residents in need of podiatry services involved notifying the unit secretary when long toenails were observed, so the resident could be added to the next podiatry visit. However, the nurse interviewed was unaware that this resident required toenail care, indicating a breakdown in the facility's process for ensuring necessary podiatry services were provided.