Failure to Ensure Call Light Accessibility for Resident with Cognitive Impairment
Penalty
Summary
The facility failed to accommodate the needs of a resident with severe cognitive impairment and multiple psychiatric diagnoses by not ensuring the resident's call light was within reach, as required by the care plan and facility policy. During observation, the resident was found lying in bed without a call button accessible, and stated she did not have one, relying instead on waving or calling out to staff for assistance. Further inspection revealed the call light was on the floor under the bed, and both an LPN and a nursing assistant confirmed that staff are expected to ensure call lights are within reach before leaving a resident's room. The director of nursing also affirmed the importance of call light accessibility for resident communication. Facility policy directs staff to make call lights accessible from the bed, toilet, shower, and floor.