Failure to Provide Timely Podiatry Services for Resident with Foot Care Needs
Penalty
Summary
The facility failed to assess and obtain podiatry services for a resident with significant foot care needs. Observations revealed that the resident's toenails were malformed, thickened, discolored, and extended past the tips of the toes. The resident expressed a need for a podiatrist to cut their toenails. Staff interviews indicated that the resident's name was placed in a folder for the Social Worker to add to the podiatry list, but the issue had not been previously brought to the attention of nursing staff by aides. Documentation showed that nail care was provided as needed, but did not specify whether this included toenails, and there was no evidence that the resident had refused podiatry or nail care services. The resident had multiple medical diagnoses, including chronic respiratory failure, end stage renal disease, and dependence on dialysis, and was cognitively intact. Physician orders allowed for podiatry services as needed, and the care plan required assistance with personal hygiene. Interviews with facility leadership revealed uncertainty about the frequency of podiatry visits and a lack of clarity regarding the process for referring residents to podiatry services. The deficiency was identified through observations, record reviews, and staff interviews, which demonstrated a breakdown in communication and follow-through regarding the resident's foot care needs.