Failure to Coordinate Podiatry Care for Dependent Resident
Penalty
Summary
A resident with a history of stroke and hypertension, who was dependent on staff for activities of daily living and not ambulatory, was observed to have overgrown, thick, and yellow toenails, including an ingrown toenail that caused discomfort and prevented her from wearing shoes or socks. The resident reported that a nurse aide had trimmed some of her smaller toenails a few days prior, but she had not been seen by a podiatrist, despite her ongoing discomfort and request for podiatry care. Interviews with nursing staff and the Director of Nursing (DON) revealed that the resident was supposed to be seen by the facility's podiatrist during a recent visit but was not, and there was uncertainty as to why she had been missed. The DON confirmed that the resident had not been assessed by podiatry since admission, despite being on the list for the previous podiatry visit. The facility expected residents' toenails to remain trimmed and for podiatry to be consulted if issues arose, but this did not occur for the resident in question.