Failure to Provide Routine and Appropriate Foot Care
Penalty
Summary
The facility failed to provide appropriate foot and nail care, including toenail trimming, for four residents who were reviewed for nail care. Observations revealed that multiple residents had thick, long, yellowed, and curled toenails, with some residents reporting pain and difficulty wearing shoes due to the condition of their nails. Certified Nursing Assistants (CNAs) acknowledged that the toenails had not been cut for a significant amount of time and that they were unable to trim certain residents' toenails due to their condition. The facility's nail care policy requires regular assessment and trimming of nails, with specific provisions for residents with diabetes or circulation problems, but these procedures were not followed for the affected residents. Interviews with residents and staff indicated that nail care was not consistently provided, with some residents stating they could not recall the last time their toenails were trimmed or that it had been almost a year since their last nail care. Staff interviews further revealed that access to podiatry services was limited to residents with certain insurance coverage, and the affected residents were not on the list to receive mobile medical podiatry. The DON stated that nail care was supposed to be provided on shower days, but this was not consistently implemented, resulting in untrimmed toenails and unnecessary pain for the residents.