Failure to Provide Access to Communication Device for Nonverbal Resident
Penalty
Summary
Resident 4, who has a traumatic brain injury and a voice and resonance disorder resulting in an inability to speak, was not provided access to their Tobii communication device. Multiple observations over several days showed the device was turned off and placed in the corner of the resident's room, rather than being available for use. Staff interviews revealed that nursing assistants and an LPN had never used the device, with some staff unaware of its existence. Communication with the resident was limited to thumbs up/down or hand signals, despite the resident's care plan indicating the need for alternative communication methods. Collateral contacts and a speech therapist confirmed that the device was not being used due to lack of staff training. When the device was set up by the speech therapist, the resident was able to use it effectively to communicate specific needs, such as requesting a shower. The resident also indicated that staff did not routinely ask about their preferences for water, bedtime, or participation in activities. This deficiency was noted as a repeat issue from a previous survey.