Failure to Provide Routine Foot Care
Penalty
Summary
A deficiency was identified when a resident with multiple medical conditions, including hypertension, muscle weakness, atrial fibrillation, and bone disorders, was observed to have long toenails, with some curling over the tops of her toes. The resident required staff assistance for lower body dressing, bathing, transfers, mobility, and personal hygiene, as documented in her care plan and MDS. The care plan also directed staff to monitor for brittle nails and provide assistance with footwear. Despite these documented needs, the resident's toenails had not been trimmed for an extended period, as observed by a licensed nurse who noted the condition and acknowledged the lack of recent foot care. Interviews with staff revealed confusion regarding responsibility for the resident's nail care, with some believing it was the nurse's duty and others stating it was the responsibility of CNAs during showers. The facility's nail care policy required routine trimming and filing of nails on a regular schedule and as needed. However, the lack of clear assignment and follow-through resulted in the resident not receiving appropriate foot care, as evidenced by the condition of her toenails at the time of the survey.