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F0558
D

Failure to Provide Accessible Call Bell, Telephone, and Water for Visually Impaired Resident

Salisbury, North Carolina Survey Completed on 11-19-2025

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 provide necessary accommodations for a visually impaired resident, resulting in the resident's inability to consistently access essential items such as the call bell, telephone, and water cup. Multiple observations revealed that the call bell was frequently placed out of the resident's reach, often left on a recliner behind him or across his bed, making it inaccessible when he was in his wheelchair. The resident, who was legally blind and had a history of falls, was observed attempting to locate the call bell by reaching and patting around but was unable to find it. Staff interviews confirmed that the call bell was routinely placed in locations the resident could not access independently, and the resident often had to yell for assistance or rely on his roommate to activate the call bell. The resident also experienced difficulty accessing his telephone, with observations showing that multiple cordless phones were out of his reach, resulting in numerous missed calls. The resident expressed frustration at being unable to answer the phone himself and indicated that his roommate frequently answered calls for him. Additionally, the resident was unable to reach his water cup, which was placed on a bedside table out of his reach, and he was observed attempting unsuccessfully to access it. Staff interviews corroborated that the resident had trouble maneuvering around his room due to his visual impairment and the placement of furniture, further limiting his ability to reach necessary items. The care plan for the resident included interventions such as keeping the call bell and frequently used items within reach and advising the resident of their location. However, observations and staff interviews demonstrated that these interventions were not consistently implemented. Staff acknowledged placing items out of the resident's reach and relying on the roommate to assist, rather than ensuring the resident's independent access to essential items as outlined in the care plan.

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