Failure to Arrange Podiatry Care for Dependent Resident
Penalty
Summary
A resident with a history of cellulitis of the left lower limb, chronic kidney disease, and congestive heart failure was admitted to the facility and was dependent on staff for personal hygiene, including nail care. The resident was non-ambulatory and cognitively intact. During a quarterly assessment, it was noted that the resident's great toenails were long, thick, and yellow, extending beyond the end of the toes. The resident reported that nursing staff had not offered a podiatry consult and expressed a desire for a podiatry visit from the facility's onsite provider. There was no documentation in the medical record indicating that the resident had been seen by podiatry. A nursing assistant observed the resident's toenails to be overgrown and reported feeling unable to trim them, stating she notified a nurse of the need for a podiatry consult. However, the nurse was unaware of this report and had not initiated a consult. The DON stated that toenail care was to be provided by nursing staff, and if unsuccessful, a podiatry consult should be offered. The DON confirmed that although an attempt to trim the resident's toenails was made in May, which the resident declined, a podiatry consult was not offered at that time as required.