Failure to Arrange Audiology Services for Resident with Hearing Loss
Penalty
Summary
The facility failed to arrange for an audiology appointment for a resident with a documented history of hearing loss. The resident was admitted with a diagnosis of hearing loss, and repeated Minimum Data Set (MDS) assessments over the course of a year documented moderate to highly impaired hearing, with no hearing aid or other hearing appliance in use. The resident's care plan identified communication problems related to hearing impairment, and interventions included discussing communication difficulties and administering ear drops for wax build-up. Despite a physician's order to consult audiology as needed and ongoing complaints from the resident about hearing difficulties, there was no evidence that an audiology referral was made. Interviews with staff and the resident's health care proxy revealed that the resident's hearing had worsened over the past year and that the issue was discussed in a care plan meeting. However, care plan meeting notes did not document the request for audiology services, and the medical records staff confirmed that no referral for audiology had been made, despite the audiologist visiting the facility quarterly. The resident was not included on the list for the most recent audiology visit, and staff turnover contributed to a lack of follow-through on the referral process.