Failure to Ensure Call Light Accessibility and Adequate Linen Supply
Penalty
Summary
Surveyors identified that staff failed to ensure call lights were within reach for two residents who required assistance, despite care plans specifying this intervention. One resident, with a history of stroke, impaired mobility, and dependence for toileting and personal hygiene, was observed with her call light on the floor, out of reach. Another resident, who was legally blind and at risk for falls, was found with her call light draped over a chair or pinned above her head, both times inaccessible. Both residents confirmed they could not reach their call lights, and staff interviews verified the call lights were not within reach as required by facility policy and care plans. Additionally, the facility failed to maintain a sufficient supply of clean linens for resident use. Observations revealed a lack of clean towels and washcloths in multiple shower rooms, and a resident reported delayed morning care due to the unavailability of clean towels. Staff interviews confirmed the shortage and indicated a lack of awareness among management and laundry staff regarding the insufficient linen supply, resulting in delayed care for at least one resident and the potential to affect others.