Failure to Coordinate Timely Audiology Follow-Up for Hearing Loss
Penalty
Summary
The facility failed to coordinate timely follow-up care for a resident with significant hearing loss due to hardened ear wax in both ears. The resident, who has diagnoses including Alzheimer's disease, Parkinson's disease, vascular dementia, and paraplegia, was noted by an audiologist to have severe wax buildup that was only partially removed during an initial visit. The audiologist's plan included the use of wax softening drops and a follow-up appointment for further removal, but this follow-up did not occur as scheduled. During a COVID-19 outbreak, the facility restricted outside physician visits, which delayed the resident's access to the audiologist. After the outbreak ended, staff did not reschedule the audiologist's visit for the resident, and the resident was not seen during the next available audiology visit. Staff interviews revealed a lack of awareness regarding the resident's need for further ear wax removal and the audiologist's recommendations. The resident continued to experience severe hearing impairment, with staff and family noting that hearing aids were ineffective and communication was significantly hindered. Documentation showed that the resident received wax softening drops as ordered, but the necessary follow-up for wax removal was not arranged. The care plan identified the resident's highly impaired hearing and recommended referral to an ear, nose, and throat doctor for wax removal, but this intervention was not implemented. Staff continued to use alternative communication methods, such as writing and speaking loudly, but these were ineffective due to the resident's concurrent vision impairment and lack of updated glasses.