Failure to Provide Hearing Treatments and Maintain Hearing Devices
Penalty
Summary
The deficiency involves the facility’s failure to provide necessary hearing treatments and maintain hearing devices for a resident with documented highly impaired hearing. The resident’s EHR showed a diagnosis of cognitive communication deficit and a need for assistance with personal care, while a recent MDS documented intact cognition, independence with footwear, and the need for varying levels of assistance with ADLs. The same MDS documented that the resident had highly impaired hearing. The resident’s care plan, including a revision dated 04/06/22 instructing staff to anticipate and meet the resident’s needs, lacked any interventions specifically addressing the resident’s impaired hearing as of 12/03/25. An audiology report dated 12/22/25 documented impacted cerumen, and the facility’s standing orders included Debrox ear drops and ear flushing for cerumen impaction. The resident’s EHR contained a standing order dated 12/23/25 for Debrox ear drops for wax buildup, and the December MAR showed Debrox was administered on multiple dates in December. However, there was no documentation in the progress notes that staff assessed the effectiveness of these Debrox treatments. The MARs for January and February lacked evidence of any Debrox treatments. During observation, the resident moved closer and tilted and turned his head when asked questions and reported difficulty hearing due to wax buildup. The resident also reported having hearing aids that did not work and that staff only cleaned them occasionally and not recently. A CNA stated she would check hearing aids and notify the nurse if they did not work, and an LN stated she would verify hearing aid function and notify the DON if there were issues, also stating the resident’s ears were cleaned regularly. An administrative nurse stated she expected daily verification that hearing aids were operational and that staff should notify leadership for repair or replacement and report hearing concerns to the provider. The facility’s policy on care of hearing-impaired residents required staff to assist with locating resources, scheduling appointments, arranging transportation, and assisting with care and maintenance of hearing devices, which was not reflected in the documented care and follow-through for this resident.
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