Failure to Implement and Follow Audiology Consults and Treatments
Penalty
Summary
The deficiency involves the facility’s failure to ensure residents received proper treatment and services to maintain hearing abilities, as required by its own consult policy and physician orders. The facility’s Consults Policy and Procedures dated 8/27/25 requires nursing staff to notify the attending provider of consulting providers’ recommendations, review the provider’s acceptance, and monitor compliance with recommended treatment. Multiple residents had physician orders authorizing or directing audiology services, but their clinical records either lacked evidence that audiology assessments were completed or that recommended treatments were implemented. One resident admitted with traumatic brain injury, obesity, stroke, and atrial fibrillation had an order allowing audiology services in place since 12/20/16, yet no audiologist assessment was documented from admission through the current review period. Another resident with autism, intellectual disabilities, obesity, and visual disabilities had an order for audiology services from admission, but no audiologist assessment was found in the record. For several other residents, audiology assessments were completed but the recommended treatment was not carried out. A resident with quadriplegia, seizures, dementia, glaucoma, and kidney disease had audiology assessments on two occasions identifying impacted cerumen in the left ear and recommending Debrox ear drops, but the MAR for the corresponding months did not show any Debrox order. Another resident with anoxic brain damage and dementia had an audiology assessment identifying impacted cerumen in the left ear with a recommendation for Debrox drops, yet the MAR did not include an order for Debrox. A further resident with stage IV kidney disease, schizophrenia, and unspecified psychosis had two audiology assessments identifying impacted cerumen in both ears and recommending Debrox drops, but the MAR for both months reviewed did not show any Debrox orders. In an interview, the DON confirmed the facility failed to ensure these residents received proper treatment and services to maintain hearing abilities.
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