Failure to Provide Timely and Appropriate Foot Care
Penalty
Summary
Two residents were found to have excessively long toenails that required trimming, indicating a failure by the facility to provide appropriate foot care as outlined in their own policy. Both residents had signed podiatry consent forms on file, but there was no documentation that either had received podiatry services since admission. One resident had a diagnosis of diabetes mellitus, which can complicate foot care needs, while the other had dementia. Observations by the surveyor confirmed that both residents' toenails were very long and in need of attention. Interviews with staff revealed that the process for scheduling podiatry services was not consistently followed. The unit secretary explained that residents are added to the podiatrist's list after consent forms are signed, but acknowledged that both residents were not included on the list for podiatry visits. The podiatrist had previously visited the facility during early morning hours, and there were concerns that some residents were reported as seen when they were not, as confirmed by resident feedback. The unit secretary also reported communication issues with the podiatry group, including missed emails and lack of follow-up. Medical record review and staff interviews confirmed that despite the presence of signed consents, neither resident had documentation of receiving podiatry care. In one case, a nurse assessed a resident's toenails and determined they were too thick and difficult to trim safely, but no podiatry service had been provided up to that point. The lack of timely and appropriate foot care for both residents constituted a deficiency in meeting their care needs as required by facility policy.