Failure to Ensure Resident Access and Assistance With Prescribed Hearing Aid
Penalty
Summary
The facility failed to ensure that a dependent resident received staff assistance with the use of a prescribed hearing aid. The resident’s EMR documented dementia with severely impaired cognition, a history of cerebral infarction, and an ear malformation causing hearing impairment. A Significant Change MDS and subsequent Quarterly MDSs showed the resident wore a hearing aid and relied on staff to have needs met, with no change in hearing aid use. The resident’s care plan directed staff to ensure availability and functioning of adaptive communication equipment, including a right-ear hearing aid to be worn during the day, removed at night, and stored and charged at the nurses’ station. Physician orders allowed for specialist care, including an audiologist, as needed. Activity notes documented that the resident was hearing impaired and wore a right-ear hearing aid when available, and that the resident had limited communication. During multiple observations, the resident was seen in a wheelchair and in the dining room without a hearing aid in place. Multiple CNAs and a CMA reported they had never seen the resident with a hearing aid and did not know if the resident was care planned for one. The Activity Director and Administrative Nurse F gave conflicting information, with the Activity Director initially stating the resident did not have a hearing aid and staff had to speak loudly in the resident’s right ear, and later stating the hearing aid had stopped working and would not hold a charge. The Social Service Designee reported the hearing aid had broken months earlier, that attempts to contact the resident’s durable power of attorney about repair had been unsuccessful, that she was unsure about coverage or personal funds for repair, and that she did not think the resident ever had an audiology appointment. Administrative Nurse D stated she expected staff to ensure hearing aids were offered and placed as ordered and reported that an unnamed nurse had purchased a hearing aid for the resident, which had been at the nurse’s desk charging. The facility did not provide a policy for hearing aids.
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