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F0919
D

Delayed Response to Resident Call Lights

Ventura, California Survey Completed on 04-28-2025

Penalty

Fine: $8,278
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The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.

Summary

The facility failed to ensure timely responses to resident call lights, as required by its own policy and procedure, which states that call lights should be answered promptly. During observations, multiple call lights in resident rooms were illuminated and accompanied by a loud buzzing noise at the nursing station, with some remaining unanswered for extended periods. Staff interviews revealed that call lights are sometimes answered by non-nursing staff, such as a respiratory therapist, particularly when residents require suctioning. One resident reported that staff response to call lights typically takes about 30 minutes, indicating a persistent issue. Further observations showed a licensed nurse present at the nursing station while call lights continued to buzz, but the nurse did not respond, citing being occupied with an admission and the presence of three CNAs, none of whom were observed nearby. The Director of Nursing confirmed that the facility's expectation is for call lights to be answered within five minutes and that all staff are responsible for responding. These findings demonstrate a pattern of delayed responses to resident call lights, with staff either not present or not responding in a timely manner.

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