Failure to Provide Timely Podiatry Services for Resident with Foot Complications
Penalty
Summary
The facility failed to obtain timely professional podiatry services for a resident with diabetes, polyneuropathy, and peripheral angiopathy, who was at increased risk for foot complications. Clinical records showed that the resident had thickened nails, burning sensations in both feet, and extensive dry skin, with podiatry assessments documented in January and May. Despite daily application of prescribed lotions by licensed nursing staff, there was no evidence of podiatry services provided for over three months after the last assessment in May, even though the resident had ongoing symptoms and risk factors for wound development. The resident reported a painful, raised area on her right foot, believed to be a callous, and could not recall her last podiatry visit. Observation confirmed a hardened, calloused, and dry area on the right foot, which appeared to have developed over time. Staff interviews and record reviews confirmed that no staff had identified the change, notified a physician, or arranged for podiatry services in a timely manner, despite daily foot checks being required by physician order.