Failure to Provide Proper Hearing Services and Devices
Penalty
Summary
The facility failed to ensure that residents with hearing impairments received proper treatment and assistive devices, including timely audiology consultations and consistent use of hearing aids or alternative communication devices. For one resident with a diagnosis of unspecified hearing loss and moderately impaired cognition, staff were observed not using communication devices, and there was no evidence of an audiology consult in the resident's electronic health record. The care plan included approaches such as exploring technology and providing assistance with communication devices, but these were not implemented. Staff communicated by speaking loudly in the resident's ear, and the resident did not have hearing aids or other hearing devices available. The resident had previously misplaced hearing aids and did not want staff assistance in locating them, and staff were unaware of the last time the hearing aids were used. Another resident with cognitive communication deficits and Alzheimer's disease was observed multiple times without hearing aids, despite a physician's order and care plan directing daily placement of hearing aids. The medication administration record indicated that the task was signed as completed, but direct observation and staff interviews revealed that the hearing aids were not in use and staff were largely unaware of the resident's need for hearing aids. Several staff members, including CNAs, LPNs, and other personnel, did not know whether the resident had hearing aids or where to find information about them, even though this information was documented in the care plan, physician's orders, and assignment sheets. The resident was also observed to have difficulty communicating, and staff often resorted to raising their voices rather than ensuring the use of hearing appliances or alternative devices like a pocket talker. The lack of staff awareness and failure to follow documented care plans and physician's orders resulted in residents not having access to necessary hearing devices, which impeded their ability to communicate and interact with their environment in a comfortable and dignified manner. The deficiency was further evidenced by staff not utilizing available communication aids, not being familiar with residents' needs as documented, and not ensuring that hearing aids were in place as required.