Failure to Ensure Call Device Accessibility for Resident with ADL Deficit
Penalty
Summary
A deficiency was identified when a resident with an ADL/self-care performance deficit and cognitive impairment was repeatedly observed without access to a call device while in bed. Multiple observations over several days documented that the call device was either hanging on the wall by the resident's feet, not within reach, or on the floor at the foot of the bed. The resident was observed in various states of dress, sometimes wearing only a brief, and at times with no blankets on the bed. The overbed table and breakfast tray were also noted to be positioned in ways that did not facilitate access to the call device. Interviews and record reviews confirmed that facility policy requires call lights to be within easy reach of residents when in bed or confined to a chair. The resident's care plan specifically included an intervention to encourage use of the call bell for ADL assistance. The DON confirmed that the call device should have been within reach at all times, but this was not consistently ensured for the resident in question.