Failure to Provide Timely and Adequate Foot Care
Penalty
Summary
A deficiency was identified when a resident with a history of epilepsy, hemiplegia, and hemiparesis following a stroke was found to have long, thick toenails and dry, flaky skin on their feet. The resident, who had moderate cognitive impairment and required dependent assistance for personal hygiene, reported that their nails were not being adequately cared for. Observations by nursing staff confirmed the condition of the resident's feet, and it was noted that the resident had not seen a podiatrist for approximately eight months, despite having a physician's order for podiatry evaluation and treatment as indicated. Review of the resident's care plan indicated that staff were to observe finger and toenails on shower days to determine if trimming was needed, but there was no documentation of care refusals or evidence that this was being consistently done. The facility's policy required referrals to ancillary providers based on individualized needs, but the resident's last podiatry visit was significantly delayed. The deficiency was attributed to the facility's failure to provide timely and adequate foot care, including appropriate podiatry services, for the resident.