Failure to Provide Replacement Eyeglasses for Resident with Impaired Vision
Penalty
Summary
A resident with severe cognitive impairment and multiple medical diagnoses, including heart failure, chronic kidney disease, and anxiety, was identified as needing reading glasses following an eye consultation. The resident's Minimum Data Set indicated impaired vision, with the ability to see large print but not regular print, and a need for substantial assistance with activities of daily living. Despite this documented need, the resident was observed without eyeglasses after his previous pair broke, and he expressed agitation about not having replacement glasses. Interviews with facility staff revealed that a Certified Nursing Assistant had informed the Social Services Director (SSD) about the need for new eyeglasses approximately two weeks prior, but the SSD had not taken any action to address the issue. The SSD acknowledged awareness of the need for glasses for about a week but admitted to not following up. The Director of Nurses confirmed that the SSD should have contacted the optometrist upon being informed. The facility's policy requires ensuring access to vision services and assistive devices, but this was not followed in the resident's case.