Failure to Ensure Telephone Access for Residents and Families
Penalty
Summary
Facility staff failed to ensure that residents and family members could reliably contact the facility via telephone. Multiple attempts by the state agency to reach the facility by phone on several occasions went unanswered, and there was no option to leave a message. Interviews with staff, the Ombudsman, family members, and residents confirmed ongoing issues with unanswered calls. A registered nurse acknowledged that phones sometimes went unanswered, especially during periods of short staffing, and the Ombudsman reported receiving complaints from families about this issue. Family members described repeated unsuccessful attempts to contact the facility, including one instance where a family member had to involve the police for a wellness check due to lack of response. Outside physicians also reported being unable to reach facility staff. A resident reported that after waiting 90 minutes for a response to his call light, he attempted to call the facility for assistance but received no answer, ultimately contacting the police for help. The administrator was aware of previous concerns but was not aware of the specific phone system issues on the dates in question. These findings indicate that the facility did not provide immediate access to residents as required, affecting the ability of residents and their families to communicate with staff and receive timely assistance.