Failure to Provide Recommended Orthopedic Boot for Resident with Limited Mobility
Penalty
Summary
The facility failed to follow podiatry recommendations for a resident with significant mobility limitations and a severe right foot deformity. The resident, who had diagnoses including right foot talipes equinovarus, hemiplegia, muscle weakness, and limited ambulation, was dependent on a manual wheelchair and had a care plan indicating the need for appropriate mobility devices and interventions. The care plan also noted the resident's risk for pressure areas and skin tears, and included a podiatry recommendation for new shoes due to worn-out footwear. Despite this, the resident's orthopedic boot was observed to be in poor condition, with a worn-down bottom, a hole in the heel, and visible dirt and wear. Interviews with staff confirmed that the resident rarely wore the orthopedic boot except for outside appointments, and the DON acknowledged that the podiatrist's recommendation for a new boot had not been followed up on. The resident expressed a desire for a new orthopedic boot to assist with foot positioning and stated he would wear it regularly if provided. The failure to obtain and provide the recommended orthopedic boot constituted a deficiency in maintaining and improving the resident's range of motion and mobility as required.