This regulation requires nursing facilities to assist residents in accessing vision and hearing services by making appointments and arranging transportation to appropriate practitioners or device providers. Facilities are not required to directly provide vision or hearing devices or comprehensive audiological evaluations, but must help residents and their representatives identify available resources (e.g., Medicare/Medicaid, community programs) to obtain needed services. Compliance is assessed through review of care plans, assessments, physician orders, and direct observations.
View official sourceF685 (Rev. 173, Issued: 11-22-17, Effective: 11-28-17, Implementation: 11-28-17) §483.25(a) Vision and hearing To ensure that residents receive proper treatment and assistive devices to maintain vision and hearing abilities, the facility must, if necessary, assist the resident— §483.25(a)(1) In making appointments, and §483.25(a)(2) By arranging for transportation to and from the office of a practitioner specializing in the treatment of vision or hearing impairment or the office of a professional specializing in the provision of vision or hearing assistive devices. INTENT The intent of this regulation is to ensure the facility assists the resident in gaining access to vision and hearing services by making appointments and by arranging for transportation. DEFINITIONS Assistive devices to maintain vision include, but are not limited to, glasses, contact lenses, magnifying lens or other devices that are used by the resident. Assistive devices to maintain hearing include, but are not limited to, hearing aids, and amplifiers. INTERPRETIVE GUIDANCE This requirement does not mean that the facility must provide refraction, glasses, contact lenses or other assistive devices, conduct comprehensive audiological evaluations (other than the screening that is a part of the required assessment in §483.20(b)) or provide hearing aids or other devices. The facility’s responsibility is to assist residents and their representatives in locating and utilizing any available resources (e.g., Medicare or Medicaid program payment, local health organizations offering items and services which are available free to the community) for the provision of the services the resident needs. This includes making appointments and arranging transportation to obtain needed services. In situations where the resident has lost their device, facilities must assist residents and their representative in locating resources, as well as in making appointments, and arranging for transportation to replace the lost devices. Investigative Summary: Use the Activities of Daily Living and Communication-Sensory Critical Element (CE) Pathways along with the above interpretive guidelines when determining if the facility meets requirements to ensure that residents receive proper treatment and assistive devices to maintain vision and hearing abilities. Summary of Vision and Hearing Investigative Procedure Briefly review the most recent comprehensive assessments, comprehensive care plan, and physician orders to determine if the facility assists residents in gaining access to vision and hearing services by making appointments, and arranging for transportation. Observations, interviews, and record reviews should be utilized to corroborate concerns identified. If the resident has been in the facility for less than 14 days (before completion of all the Resident Assessment Instrument (RAI) is required), review the baseline care plan which must be completed within 48 hours to determine if the facility is providing appropriate care and services based on information available at the time of admission.