Failure to Provide Diabetic Foot Care and Schedule Podiatry Appointment
Penalty
Summary
The facility failed to provide appropriate foot care for one resident with a history of diabetes and bilateral lower extremity amputations. Despite physician orders and hospital recommendations for diabetic foot care, including daily washing, moisturizing, and inspection of the feet, the facility did not ensure these interventions were consistently performed. Documentation in the Treatment Administration Record and nursing progress notes showed multiple missed entries for diabetic foot care, and interviews with nursing staff revealed a misunderstanding of the required care, with some staff only inspecting the feet and not washing or applying lotion as needed. Observation of the resident confirmed dry, flaky skin and removal of skin with dressing changes, indicating inadequate foot care. Additionally, the facility failed to schedule a podiatry appointment as ordered by the physician and recommended by the hospital following the resident's discharge. Despite a specific order entered by the DON for a podiatry consult, there was no evidence that an appointment had been scheduled more than three weeks after the order was placed. Interviews with facility staff confirmed that the receptionist was not aware of the need to schedule the appointment until the day of the survey, further demonstrating a lapse in following through with necessary medical care for the resident.