Failure to Ensure Call Light Accessibility and Timely Response
Penalty
Summary
The facility failed to reasonably accommodate the needs and preferences of two residents by not ensuring proper placement and timely response to call lights. For one resident with right-sided weakness due to a cerebral infarction, the call light was placed on the right side of the bed, making it inaccessible to her. This resident expressed being cold and unable to reach the call light to request assistance. Both a CNA and the Director of Staff Development confirmed that the call light should have been placed on the left side, as documented in the resident's care plan, to allow her to call for help. Another resident, also with a history of cerebral infarction, reported that staff took 30 minutes or longer to answer her call lights. During observation, another resident was heard calling for help, and their call light remained on for about 17 minutes before a CNA responded. Staff interviews and facility policy indicated that call lights should be answered within seven to fifteen minutes, and that all staff are responsible for responding promptly. The care plans for both residents emphasized the need for timely assistance and the use of call lights, but these procedures were not followed.