Failure to Maintain Working Call Light System in Resident Room
Penalty
Summary
The facility failed to ensure that a working call system was available for residents in a specific room, resulting in both beds being without a functioning call light. Observations confirmed that the call lights for two residents were not operational, and one resident reported that the issue had persisted for several days. The resident stated that staff had been informed, but no alternative means of calling for assistance was provided. The other resident in the room was nonverbal and severely cognitively impaired, making it impossible for the surveyor to interview him regarding the deficiency. Interviews with nursing staff revealed they were unaware of the malfunctioning call lights and could not determine how long the issue had existed. The Maintenance Director was also unaware of the problem, stating he only received work orders once they were entered into the facility's maintenance system. The DON and Administrator both confirmed there was no policy or regular audit process for call lights, and the system was not capable of generating call light history reports. The facility did not have a policy in place for call light checks or alternative communication methods for residents when call lights were not functioning.