Failure to Ensure Resident Call Bells Were Accessible
Penalty
Summary
Surveyors identified that the facility failed to ensure residents had access to their call bells, as required for communication with staff. During observations, four residents were found without accessible call bells: one resident's call bell was inside a bedside table drawer, another's was on the opposite side of the bed, a third had the call bell wrapped around a bed rail out of reach, and a fourth resident's call bell was found on the floor under a roommate's bed. These observations were made while residents were either in bed or seated in wheelchairs, and in all cases, the call bells were not within reach for the residents to summon assistance. Interviews with staff, including a registered nurse and a GNA, confirmed that it was their responsibility to ensure call bells were accessible, but there was no consistent process or schedule for checking call bell accessibility. The staff acknowledged the issue when it was pointed out and repositioned the call bells to make them accessible. The deficiency was further confirmed during dual observations with staff, who admitted the oversight and took immediate action to correct the placement of the call bells.