Failure to Provide Timely Podiatry Services
Penalty
Summary
The facility failed to provide timely podiatry services for one resident with significant medical needs, including dementia, polyneuropathy, and chronic pain syndrome. Observations revealed that the resident's toenails were raised, long, thickened, discolored, and fungal-like, with dry and scaly skin around the toes. Staff interviews confirmed that the resident's toenails were in need of trimming and that there were ongoing issues with insurance coverage for in-house podiatry services. Documentation of attempts to secure podiatry services or to communicate with the resident's guardian about these issues was not available. Additionally, there was no evidence that concerns regarding podiatry coverage were discussed during care conferences. The clinical record showed that the resident had previously received podiatry care, with a note indicating elongated, dystrophic, and discolored nails, and a recommendation for reassessment in nine weeks or as needed. However, there was a lack of follow-up and no documentation of further podiatry visits or efforts to address the resident's ongoing foot care needs. Facility policy required referrals to ancillary providers with resident consent and follow-up as needed, but this process was not documented or followed for the resident in question.