Failure to Respond Timely to Resident Call Lights
Penalty
Summary
The facility failed to ensure timely response to call lights for five residents, as evidenced by direct observations, resident interviews, and review of call light response time reports. Residents with moderate cognitive impairment, diabetes, heart failure, peripheral vascular disease, and end stage renal disease reported waiting between 15 minutes to as long as two hours for staff assistance after activating their call lights. These delays occurred across multiple shifts, with some residents specifically noting longer wait times during shift changes. Call light response reports confirmed that call lights remained on for over 20 minutes on numerous occasions, with the longest single wait times ranging from 33 to 39 minutes for individual residents. Residents described waiting extended periods for assistance with toileting, transfers, and other personal care needs, sometimes resulting in episodes of incontinence. The facility's own records corroborated these reports, showing repeated instances where call lights were not answered within the facility's stated goal of 10 minutes. The Nursing Home Administrator acknowledged awareness of the issue and ongoing complaints regarding delayed response times.