Failure to Promote Resident Dignity and Timely Response to Call Lights
Penalty
Summary
The facility failed to provide care and services that promote dignity and respect for multiple residents, as evidenced by extended call light wait times, negative staff comments, and lack of appropriate staff education. One resident with critical illness myopathy and end stage renal disease reported frequent delays of 30-45 minutes for call light responses, overheard staff referring to him as 'cranky,' and felt staff were retaliating against him after voicing concerns. The resident expressed feelings of anger, frustration, and being dehumanized, and stated that previous complaints to management were not addressed, leading him to stop reporting issues. Another resident with hemiplegia following a stroke, who required assistance with bed mobility and personal hygiene, reported waiting at least 30 minutes for staff to answer her call light. She described experiencing pain while waiting to be repositioned and discomfort from remaining in a soiled brief for extended periods. This resident stated that the delays made her feel sad and angry. A third resident with anxiety and depression also reported long call light wait times, particularly at night and on weekends, sometimes waiting so long that her needs went unmet and she fell asleep without assistance. Staff interviews confirmed that residents had complained about long call light wait times, especially during the night shift. Resident council meeting minutes and a confidential group interview further corroborated that multiple residents experienced extended wait times, with reports of waiting over 45 minutes during evening hours across several facility halls. The facility's own dignity policy emphasized the importance of treating residents with respect and enhancing their self-worth, but the lack of recent staff education and the ongoing issues with staff-resident interactions contributed to the deficiency.