Failure to Coordinate and Implement Podiatrist-Ordered Care
Penalty
Summary
A deficiency occurred when the facility failed to coordinate and implement care as ordered by a podiatrist for a resident with a complex medical history, including Type 2 diabetes, a left foot ulcer, chronic osteomyelitis, and a right below-knee amputation. The resident was scheduled for a follow-up podiatry appointment for surgical debridement, but missed the appointment because nursing staff did not arrange transportation. Additionally, the facility did not ensure that updated wound care orders from the podiatrist were entered into the resident's record, and there was a lack of documentation of podiatry visit notes in the resident's chart. Interviews with facility staff revealed that neither the Unit Manager nor the Assistant Director of Nursing were aware of new orders or scripts for medical clearance and antibiotics provided by the podiatrist. The process for reviewing and implementing new orders after outside appointments was inconsistently followed, resulting in the resident not receiving timely care as ordered. The resident's daughter expressed concern about the delay in care and the lack of coordination for necessary medical follow-up.