Failure to Ensure Call Light Accessibility for Visually Impaired Resident
Penalty
Summary
A deficiency was identified when staff failed to ensure that a call light was kept within reach for a resident with significant visual impairment. The resident, who had diagnoses including anxiety disorder, schizophrenia, muscle weakness, and blindness, was care planned to have the call light within reach at all times. The resident's Minimum Data Set (MDS) indicated highly impaired vision, moderate cognitive impairment, and a history of rejecting care daily, but was otherwise independent with toileting and ambulation for short distances. During multiple observations on two consecutive days, the resident was found sitting in a recliner with the call light lying on the floor out of reach. When asked, the resident, who confirmed being blind, was unaware of the call light's location and unable to access it. Staff interviews confirmed awareness of the resident's visual impairment and the requirement for the call light to be accessible, yet the deficiency persisted across several checks.