Delayed Response to Call Light and Incontinence Care for Resident Needing ADL Assistance
Penalty
Summary
A deficiency occurred when a resident who required assistance with activities of daily living (ADLs), including toileting and incontinence care, did not receive timely help from facility staff. The resident, who had diagnoses such as end stage renal disease, hypoglycemia, muscle weakness, and mobility issues, was assessed as needing substantial to maximal assistance with toileting and other ADLs and was frequently incontinent. The care plan specified that staff should anticipate and meet the resident's needs, ensure the call light was within reach, and encourage its use for assistance. On the day of the incident, the resident activated the call light to request a brief change but reported that staff typically took 30 minutes or longer to respond, sometimes making the resident wait up to an hour for assistance. Observations confirmed that the call light remained unanswered for at least 11 minutes while multiple staff members walked by the room. The resident also reported that if the assigned staff member was unavailable, other staff would instruct the resident to wait for the assigned staff, further delaying care. Interviews with CNAs revealed that licensed nurses generally did not assist with answering call lights or simple resident requests, leaving the responsibility to CNAs. However, both the LVN and DON stated that all staff were responsible for answering call lights promptly, emphasizing the importance of meeting residents' needs quickly. The facility's policy required that residents unable to perform ADLs receive necessary services to maintain their abilities, but this was not followed in the observed case.