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F0558
D

Delayed Call Light Response for Residents Needing Assistance

Stockton, California Survey Completed on 07-02-2025

Penalty

No penalty information released
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The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.

Summary

The facility failed to ensure that residents' needs were accommodated by not responding to call lights in a timely manner for at least two of four sampled residents. Observations and interviews revealed that one resident waited an extended period for assistance with changing an incontinent brief and for help moving from bed, with a call light remaining unanswered for at least 27 minutes. The resident's care plan indicated a need for substantial assistance with activities of daily living due to weakness and impaired mobility. Another resident reported waiting up to 30 minutes for staff to respond to call lights, and was observed with a call light on for 12 minutes before staff responded. This resident also required assistance with toileting and used an incontinent brief due to generalized muscle weakness and mobility issues. Additional interviews with other residents confirmed similar delays, with one resident stating the longest wait was 20 minutes and that response times were longer during the evening shift. The Assistant Director of Nursing stated that the expectation was for call lights to be answered within 1-2 minutes, or at least less than 5 minutes, and acknowledged that waits of 15 minutes or more were too long. Facility policy required prompt response to call lights by all staff, regardless of assignment. These findings demonstrate that the facility did not consistently meet its own standards or residents' needs for timely assistance.

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