F0656

D

Failure to Implement Care Plan for Vision and Hearing Devices

Tarzana, California Survey Completed on 02-27-2026

Penalty

No penalty information released

Summary

Surveyors identified a deficiency in the implementation of a resident’s comprehensive care plan related to vision and hearing needs. The resident was admitted with diagnoses including metabolic encephalopathy, UTI, hearing loss, and dementia, with assessments showing severely impaired cognition and dependence on staff for most ADLs. The resident’s care plan for impaired visual function, revised 1/6/2026, directed staff to remind the resident to wear glasses when up and to ensure the glasses were worn, clean, free from scratches, and in good repair. A separate care plan for communication problems related to bilateral hearing loss, revised 1/7/2026, indicated the resident required hearing aids to communicate and that staff were to ensure the availability and functioning of adaptive communication equipment.

On observation on 2/26/2026 at 1:45 p.m., the resident was seen sitting in a wheelchair in the lobby without eyeglasses or hearing aids in place. During a concurrent observation and interview at 1:50 p.m., the ADON confirmed that the resident should be wearing eyeglasses and hearing aids when out of bed. In a later interview at 2:45 p.m., an LVN stated the resident should be wearing hearing aids and eyeglasses when out of bed, but reported the hearing aids were not currently charged and therefore not available for the resident to wear, despite the plan of care requiring their use. The Administrator also confirmed that the resident should be wearing hearing aids and eyeglasses when out of bed as indicated in the care plans. Facility policies on care and use of hearing aids and on comprehensive care plans required assistance with hearing aids and implementation of person-centered care plans with measurable objectives and timeframes to meet identified needs.