Insufficient Staffing Leads to Delayed Call Bell Responses
Penalty
Summary
The facility failed to provide sufficient nursing staff to meet the needs of residents, as evidenced by extended call bell response times for several residents. The facility's policy requires that all residents have a call light or alternative communication device within reach and that staff respond promptly to call lights. However, multiple grievances and interviews with residents revealed that call bells were not answered in a timely manner, leading to concerns about resident safety and well-being. Resident R2's son reported that his mother experienced delays in call bell responses, which he feared increased her risk of falls. The facility's device activity report confirmed prolonged response times, with some instances exceeding 30 minutes. Resident R4 also reported long wait times for assistance, resulting in accidents, and the device activity report corroborated these claims with several instances of delayed responses. Resident R5 expressed similar concerns, noting that staff shortages contributed to the delays, and the device activity report showed multiple instances of extended wait times. Interviews with other residents and staff further highlighted the issue of insufficient staffing, particularly during busy times such as after 7:00 p.m. The Director of Nursing acknowledged the challenges in meeting call bell response expectations due to competing demands and a high number of residents requiring assistance. Despite the facility's efforts to address these concerns, the report concluded that the facility failed to provide adequate nursing services to ensure the highest practicable well-being of the residents involved.
Plan Of Correction
The facility submits this plan of correction under procedures established by the Department of Health in order to comply with the Department's directive to change conditions which the Department alleges are deficient under State and Federal regulations relating to long term care. This plan of correction should not be construed as either a waiver of the Facility's right to appeal and to challenge the accuracy or severity of the alleged deficiencies or an admission of past or ongoing violations of State and Federal regulatory requirements. Residents will be educated on the grievance process, expectations for call bell response times, and the opportunity to share their concerns regarding staffing and call bell response times with the facility leadership anonymously, verbally, and/or in writing through resident council meetings. R2, R4, R5, R6, R7, and R8 will be interviewed to determine if improvements have been made. All residents have the potential to be affected by the deficient practice. Education for all nursing staff was completed regarding answering call bell times promptly (with a goal of less than 15 minutes), when rounding. An audit will be conducted by the Director of Nursing/designees on call light response times using the call light report five days a week for two weeks, then 4 times a week for an additional 2 weeks and then 3 times a week for an additional two weeks for a total of 6 weeks. The call bell report will be reviewed by DON/designees to track and trend peak call bell times to improve on timely response to resident needs. Any residents that do not have their call bell answered within the accepted time frame of less than 15 minutes will be interviewed and team members will be educated. At the next resident council meeting, we will discuss call bell response times and if they have improved. The results of these audits will be shared with the administrator and reviewed by the QAPI Committee.