Failure to Provide Timely Podiatry Care for Resident with Foot Complications
Penalty
Summary
A resident with a history of hemiplegia, hemiparesis following cerebral infarction, COPD, type 2 diabetes with diabetic peripheral angiopathy with gangrene, anxiety, and peripheral vascular disease was admitted to the facility and had not been seen by a podiatrist for approximately six months. The resident reported to several staff members the need to see a podiatrist, and staff responses indicated he would be added to the list for a podiatry visit. Upon observation, the resident's left big toenail was found to be extremely overgrown, curved, thickened, jagged, and discolored, with additional overgrown toenails and a prior amputation of the left third toe digit. A Licensed Practical Nurse confirmed the resident's request for podiatry care and acknowledged the toenails were overgrown. The Director of Nursing stated that the facility sends a census to the podiatrist before their bimonthly visits and notifies them of new admissions, but confirmed the resident had not yet been seen. The facility's policy requires residents with foot disorders or medical conditions associated with foot complications to be referred to qualified professionals, but this was not followed in this case.