Failure to Provide Timely Podiatry Services and Diabetic Footwear
Penalty
Summary
The facility failed to ensure that appropriate podiatry services were obtained for a resident with diabetes and neuropathy. The resident was identified as having a self-care deficit and required ongoing at-risk foot care, as documented in her care plan and podiatry notes. Despite a podiatry visit recommending continued care and a follow-up in nine to twelve weeks, no further podiatry appointments were scheduled for the resident over several months. The resident also reported being promised diabetic shoes, but no follow-up occurred, and her care plan lacked information regarding diabetic shoes or podiatry preferences. Multiple provider notes and orders indicated the need for podiatry referral and diabetic shoes, but these were not acted upon in a timely manner. Observations revealed the resident had long toenails, dry skin, edema, and reported foot pain, stating she could not wear her current shoes. Interviews with staff indicated confusion regarding the scheduling of podiatry appointments, with the health information manager unable to provide documentation of any refusal by the resident and the director of nursing noting a lapse in follow-up due to a change in guardianship. The facility was unable to provide a written policy for referrals, and the process described by the administrator was not followed in this case, resulting in the resident not receiving necessary podiatry care and diabetic shoes as ordered.