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F0558
D

Call Light Not Kept Within Reach for Resident with Limited Mobility

Los Angeles, California Survey Completed on 06-06-2025

Penalty

No penalty information released
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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 that a resident's call light was kept within reach, as required by the resident's care plan and facility policy. During an observation, the call light was found on the floor beside the resident's bed, making it inaccessible. The resident had a history of type 2 diabetes mellitus with a foot ulcer, obesity, and physical deconditioning, which limited mobility and increased dependence on staff for activities of daily living. The resident was cognitively intact and able to communicate needs, and the care plan specifically directed staff to keep the call light within reach and encourage its use for assistance. Interviews with facility staff, including an LVN, the Director of Staff Development, and the Assistant Director of Nursing, confirmed that it was the responsibility of all staff to ensure call lights were accessible to residents at all times. Staff acknowledged that the call light should not have been on the floor and that environmental checks should include verifying the call light's placement. Review of facility policy also indicated that call cords must be placed within the resident's reach. The failure to keep the call light accessible constituted a deficiency in accommodating the resident's needs and preferences.

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