Failure to Ensure Call Light Accessibility for Resident with Hemiplegia
Penalty
Summary
A deficiency occurred when staff failed to consistently ensure that a resident with significant cognitive impairment and right-sided weakness had access to a working call light within reach. The resident's care plan identified cognitive deficits, vascular dementia, cerebral infarction, and hemiplegia affecting the right side, but did not provide specific instructions for staff to place the call light on the resident's unaffected left side. Multiple observations showed the call light was repeatedly placed on the resident's right side, which he was unable to use due to his physical limitations. Interviews with the resident confirmed he could not reach or use the call light when it was placed on his right side, and staff acknowledged the improper placement during the survey. The care plan lacked direction for staff to accommodate the resident's self-care deficits by ensuring necessary items, including the call light, were accessible on his functional side. Additionally, the facility did not have a policy available for call light use. The failure to provide the call light within reach limited the resident's ability to communicate needs, as observed and confirmed through staff and resident interviews.