Failure to Provide Ongoing Foot Care and Podiatry Services
Penalty
Summary
A resident was observed with long, curved toenails on both feet, with measurements indicating significant overgrowth. The resident reported experiencing painful toenails. During an interview and observation, the Treatment Nurse confirmed the responsibility for toenail care lies with the nursing staff, including CNAs and licensed nurses, and acknowledged that podiatry should have been notified about the resident's condition. The resident's medical record showed a history of dementia, hypertension, and acute kidney failure, and documented a previous podiatry visit diagnosing onychomycosis, dystrophic nails, and paronychia with painful nail borders. However, there was no evidence of ongoing podiatry care after the last documented visit. The Director of Nursing stated that facility policy requires regular nail care by nursing staff and that podiatry services should have been scheduled for the resident. The facility's policy emphasizes daily cleaning and regular trimming of nails to prevent skin problems and injuries. Despite these policies, the resident did not receive appropriate foot care, and there was no documentation of podiatry follow-up after the initial assessment, resulting in the resident having long, painful toenails.