Failure to Coordinate Podiatry Care for Dependent Diabetic Resident
Penalty
Summary
The facility failed to arrange or coordinate podiatry care for a dependent resident with multiple diagnoses, including diabetes, muscle weakness, stroke, and severe cognitive impairment. The resident was dependent on staff for personal hygiene and had a care plan that included regular foot inspections, encouragement of proper foot care, referral to a podiatrist, and nail trimming. Despite a physician order allowing podiatrist services and repeated requests from the resident's responsible party for toenail trimming, the facility did not provide this care. The responsible party reported making multiple requests since admission, but the resident's toenails remained untrimmed, and the resident was not added to the podiatry list for the next scheduled visit. Observations confirmed that the resident's toenails were long, thick, and extended beyond the toes. Staff interviews revealed that nurse aides were aware of the need for nail care but did not trim the nails due to the resident's diabetic status, and there was a lack of communication to nursing staff and the facility scheduler regarding the need for podiatry services. The scheduler was unaware of the issue and stated that an outside appointment would have been made if immediate attention was required. The administrator was also unaware of the responsible party's concerns and expected nursing staff to communicate such needs and ensure residents were added to the podiatry list.