Failure to Provide Prescribed Foot Care and Adaptive Equipment
Penalty
Summary
The facility failed to provide necessary foot care and treatment for a resident who was admitted for rehabilitation and nursing care following a traumatic amputation of the left foot and Achilles tendon lengthening. The consulting podiatrist evaluated the resident and recommended a custom-fitted diabetic shoe with filler to support ambulation and meet the resident's foot care needs. Despite these recommendations, there was no documented evidence that the facility arranged for the resident to be fitted for the adaptive equipment or provided transportation for this purpose. Subsequent evaluations by the podiatrist reiterated the need for the diabetic shoe, but the resident continued to lack the prescribed adaptive equipment. Observations showed the resident was not wearing any adaptive equipment and was using a wheelchair for mobility. Physical and occupational therapy notes indicated the resident experienced pain and discomfort when trialed with a boot, and interviews with the resident and staff confirmed that the recommended custom-fitted diabetic shoe was never obtained. The lack of appropriate foot care and adaptive equipment impeded the resident's ability to safely ambulate and prepare for discharge to a community setting that required stair navigation, as documented in interviews and clinical records.