Pedi-Care

03/08/2026

Surprise! Your Foot Care Wasn’t Covered.

I am often asked whether Medicare covers routine foot care. Routine foot care includes trimming and thinning toenails, removing corns and calluses, and providing hygienic or preventive foot maintenance such as cleaning and soaking the feet. In most cases, Medicare generally does not cover these routine services.

In the limited circumstances where Medicare does cover routine foot care, you are responsible for 20% of the Medicare-approved amount after meeting your Part B deductible. Covered visits are generally limited to once every 90 days. If you are seen sooner than the allowed interval, Medicare will typically deny coverage for that visit.

To qualify for Medicare-covered routine foot care, you must have a qualifying systemic medical condition that makes self-care impossible or unsafe. Your diagnosis must appear on Medicare’s list of approved conditions, and your podiatrist must document
why you cannot safely trim your own nails or remove calluses. Simply being unable to reach your feet or being blind, without an underlying qualifying medical condition, does not meet Medicare’s coverage criteria.

Medicare-Medicaid Dual Advantage plans generally use the same medical criteria when determining coverage. However, your out-of-pocket cost may be lower, with many plans charging a copayment of around $40.

The Veterans Administration (VA) also uses similar medical criteria for routine foot care coverage. If you qualify, there is typically no cost for care. However, because of limited resources, missing a scheduled 90-day appointment may mean waiting until the next
available 90-day cycle for treatment.

Some managed care programs, such as Minnesota Senior Health Options (MSHO), may cover routine foot care, but services generally require authorization from the member’s case manager.

Jennifer Ryan, RN, CFCN, CFCS

Get foot care coverage for foot injury, exam, deformity, disease, more. Use Medicare to cover podiatrist costs. See how by clicking link.

05/06/2026

Blistering heat!

Well the heat is not here yet, but as summer approaches footwear changes to strappy sandals, flip flops and comfy canvas deck shoes. These types of shoes have different pressure areas and are notorious for causing blisters. Before leaving the house this spring, carefully consider the footwear that you choose. Is it appropriate for your activity? For example, choosing to debut a pair of new summer sandals to participate in a five mile charity walk would be a great way to get a few blisters. Wearing shoes without socks may also cause blisters. In addition to well fitting footwear, there are good commercial products to help prevent blisters from forming such as special antifriction socks, antifriction patches and sprays.

Even with good prevention measures blisters may occur. Water blisters that are intact should not be broken. Keeping skin intact helps to prevent germs from entering causing infection. Covering the area with a waterproof dressing such as Tegaderm or gel blister
guard dressings keeps the area clean and allows for healing while providing pain relief. These products are available at drug stores. Please ask your pharmacist for assistance in selecting the product that is right for you and follow package directions. Should a blister become painful, red, swollen or have drainage contact your medical doctor, particularly if you are diabetic, or have peripheral vascular disease or neuropathy.

Be well and don’t let summer not rub you the wrong way.

Jennifer Ryan, RN, CFCN

16/01/2026

Self-Care - Edema Series #3

Once edema has been reduced by Complete Decompression Therapy (CDT), ongoing self-care begins. Self-care is life-long, but is easy to do and offers results of improved health and comfort. Compression hose are the primary mode of compression therapy in self-care. These hose play a key role in maintaining the results achieved with CDT. Other self-care therapies, such as edema pumps or self massage techniques, are sometimes prescribed as well, and ongoing good skin care is a must.

When edema has been reduced to the optimum level, the therapist will individually fit the proper compression hose or wraps. These may be a non-medical, ready-made garment or a custom made medical garment. When using a ready-made garment, the therapist will fit the client properly for size and choose the correct amount of compression.

The selection for custom made hose is complex and considers the exact compression needed. The patient's other health concerns and mobility are factors. CDT therapists are concerned about how their client will get the garment on each day and will adjust their recommendation accordingly. Specific measurements for size and compression are recorded and even the weave and type of fibers to be used are considered.

T.E.D. (Thrombo-Embolic Deterrent) hose, the white ones that you were provided with when at the hospital, are not used for edema. They are to prevent blood clots when you are in bed for a long period of time. Wearing hose intended for another is never a good choice and may cause more harm than good. If you suffer with edema in your legs and feet, I would encourage you to
pursue edema therapy. Jennifer Ryan RN, CFCN, CFCS

https://www.mayoclinic.org/diseases-conditions/edema/diagnosis-treatment/drc-20366532

https://lymphnet.org/page/lymphedema-therapy

Empowering people living with lymphedema through education, advocacy, and care. Explore resources, events, and support from the National Lymphedema Network.

16/01/2026

Self-Care - Edema Series #3

Once edema has been reduced by Complete Decompression Therapy (CDT), ongoing self-care begins. Self-care is life-long, but is easy to do and offers results of improved health and comfort. Compression hose are the primary mode of compression therapy in self-care. These hose play a key role in maintaining the results achieved with CDT. Other self-care therapies, such as edema pumps or self massage techniques, are sometimes prescribed as well, and ongoing good skin care is a must.

When edema has been reduced to the optimum level, the therapist will individually fit the proper compression hose or wraps. These may be a non-medical, ready-made garment or a custom made medical garment. When using a ready-made garment, the therapist will fit the client properly for size and choose the correct amount of compression.

The selection for custom made hose is complex and considers the exact compression needed. The patient's other health concerns and mobility are factors. CDT therapists are concerned about how their client will get the garment on each day and will adjust their recommendation accordingly. Specific measurements for size and compression are recorded and even the weave and type of fibers to be used are considered.

T.E.D. (Thrombo-Embolic Deterrent) hose, the white ones that you were provided with when at the hospital, are not used for edema. They are to prevent blood clots when you are in bed for a long period of time. Wearing hose intended for another is never a good choice and may cause more harm than good. If you suffer with edema in your legs and feet, I would encourage you to
pursue edema therapy. Jennifer Ryan RN, CFCN, CFCS

https://www.mayoclinic.org/diseases-conditions/edema/diagnosis-treatment/drc-20366532

https://lymphnet.org/page/lymphedema-therapy

04/11/2025

Edema series #2: Available Treatments

Regardless of the cause of lower extremity edema, the basic treatment is the same.

Compression: Stockings or wraps. Elevation: Sitting or laying with one's feet raised, preferably higher than the level of the heart, several times per day. Exercise: Walking and leg exercises to keep muscles strong and to move fluid back up and out of the legs. Sodium Reduction: Maintaining a low sodium diet. Medication: The use of diuretic medication to remove water from the body.

When these simple interventions do not do the job, Complete Decongestive Therapy (CDT) is the gold standard for treating edema. This treatment is performed by a trained physical, occupational, or massage therapist or nurse. This type of treatment includes both a treatment phase and ongoing self care. The treatment phase takes several weeks and involves manual lymph drainage massage, compression bandaging, and education on skin care and exercise training.

Another treatment used is Intermittent Pneumatic Compression Therapy (IPC). IPC involves a pneumatic sleeve being applied to the leg which inflates and deflates sequentially applying pressure to encourage fluid absorption. IPC can be used in both treatment and self-care phases. Selection and use of IPC should be done in consultation with a trained CDT therapist.

Jennifer Ryan, RN, CFCN

08/09/2025

Edema Series #1 Why are my feet swollen?

I am often asked by clients “Why are my feet swollen?" This is not a simple question.

The first step in dealing with edema is to identify the cause. It is best to consult with a medical provider and if the cause can not be simply eliminated, referral for edema therapy for management is appropriate.

Lower extremity edema refers to swelling in the legs, ankles, or feet due to the accumulation of excess fluid in the tissues. This condition can result from a variety of causes, ranging from benign to serious underlying health issues.

One of the most common causes is venous insufficiency, where the veins in the legs struggle to return blood to the heart efficiently. This leads to fluid leaking into surrounding tissues. Prolonged standing or sitting, especially in hot weather, can also cause temporary edema due to gravity and blood pooling. Injury or surgery involving the leg, ankle, or foot can also cause swelling.
Heart failure is a more serious cause, particularly when the right side of the heart is affected, leading to fluid backup in the lower body. Similarly, kidney disease can result in the body retaining excess sodium and fluid, contributing to swelling. Liver disease, such as cirrhosis, may reduce the production of proteins like albumin, which help keep fluid in the blood vessels. Other contributors include medications, infections, blood clots, and lymphatic obstruction.

Treatment and management are necessary to prevent secondary conditions such as sores and infections. Once the reason for edema has been found, treatment can begin.
Jennifer Ryan, RN, CFCN, CFCS

https://medlineplus.gov/ency/article/003104.htm
https://www.med.umich.edu/1libr/Homecare/MVN/LEEdema.pdf
https://www.mayoclinic.org/diseases-conditions/edema/diagnosis-treatment/drc-20366532

Learn about symptoms, causes and treatment of swelling caused by too much fluid in body tissues.

22/05/2025

Kick Off Your Shoes!

Kicking off your shoes is not just relaxing; it may be good for you. Going barefoot helps to strengthen the muscles in your feet, encourages better posture, and stimulates nerve endings, all things important for balance. Balance is a complex process that involves the brain, muscles, peripheral nerves, specialized sensors in tendons, equilibrium sensors in the inner ear, and the visual system. Constant messaging between these systems allows continuous adjustment of body position to maintain balance. If the nerves of the foot are never given stimulation they may grow “lazy” and may not pass on information well.

Walking barefoot on natural surfaces like grass, known as "grounding," it can reduce stress, improve circulation, and enhance your connection to nature. Many people find it calming and mentally refreshing.

While all this sounds great, I am not suggesting that you throw away your shoes and orthotics and go for it! If you are never barefoot the transition to barefooting must be slow and best done with the guidance of a medical professional. But how about adding some safe barefoot time? When seated in a chair there is no reason not to touch the floor or the ground with bare feet. It is important to take a moment and involve your brain, think how the surface feels, rough or smooth, warm or cold, damp or dry? Encourage your brain to pay attention to what your feet are telling it. If this goes well, you can progress to doing this while weight bearing.

While it’s not always practical everywhere, adding some barefoot time into your daily routine—especially outdoors—can offer health and wellness benefits. Jennifer Ryan RN, CFCN

28/01/2025

Sometimes, it’s the soap.

Most days that I work at least one person will ask me what moisturizer is best to put on their feet. Although this seems a simple question, it is not. Skin differs, and what works well to moisturize for some, does not for others. In general, feet like a product that is more heavy or “greasy”. Aquaphor Healing Ointment is a glycerol-based emollient that I see a high success rate with.

An important factor of dry skin prevention that is often overlooked is what soap is used. Many soaps are harsh on the skin and remove natural oils. If the natural oils are not stripped away skin will remain healthier. It is important to avoid soap with artificial fragrance and color. Antibacterial soap may be fine for handwashing but is not needed for bathing. Brands to avoid are Dial and Irish Spring.

The original Dove bar soap contains no parabens or sulfate cleansers. It is also pH-balanced to help skin retain natural moisture and has a moisturizer in it. Many liquid soaps are a better choice than bar soap as they most often have moisturizers and a balanced pH. Remember, all types of soap, whether liquid or bar, are composed of the same essential ingredients- alkali salts, fatty acids and detergent. When selecting a body soap, check the label for such words as Ph balanced, emollient and moisturizing. Soap should be used sparingly. Running water will remove most debris and germs from your skin. You need not lather up from head to toe.
Jennifer Ryan, RN, CFCN

12/12/2023

Current Care Locations - Please call 612-356-0207 for prices and availability.

Paynesville Healthcare Center, Paynesville, MN
Garden View, Watkins, MN
Koronis Place, Paynesville, MN
Serenity, St. Joseph, MN
Green Wing, Paynesville, MN
ROCORI, Cold Spring, MN
St. Francis Xavier Hall, Sartell, MN
Sauk Centre Senior Center, Sau Centre, MN
Green Roof Center, Paynesville, MN
St. Anne's Catholic Church, Kimball, MN