Failure to Respond Promptly to Resident Call Lights
Penalty
Summary
The deficiency involves the facility’s failure to ensure call lights were answered in a timely manner, as required by its own policy and expectations. One resident with diagnoses including orthostatic hypotension, end-stage renal disease, and polyosteoarthritis, and who was cognitively intact, reported that his call light remained on for more than two hours one afternoon while he waited for his urinal to be emptied and for water. He stated that no one responded to his call light from approximately 4:20 PM until 6:45 PM, despite his calling the reception desk four times to request assistance. The receptionist confirmed that residents sometimes call the front desk when call lights are not answered timely and recalled that this resident had called her, reporting he had been waiting “a while” for his call light to be answered; she then went to the floor and informed the nurse, who said she would send someone. The nurse assigned to the resident that evening stated that when she entered the room to administer pain medication, the resident told her he had been waiting over an hour with his call light on and that no one had emptied his urinal. The CNA assigned to the resident that evening reported that she only became aware of the call light after being informed by the nurse; when she entered the room, the resident told her he had been waiting more than two hours for someone to answer his call light and needed water and his urinal emptied. The CNA stated she did not hear or see the call light because she was sitting at the end of the hallway on the opposite side of the resident’s room. Another resident reported that staff were sometimes delayed in answering call lights and providing showers due to lack of staff. The DON and staff interviews confirmed that anyone can and should answer call lights, that they are expected to be answered within 15 minutes, and that short staffing sometimes affects timeliness of care, contrary to the facility’s written policy requiring prompt response to activated call lights.
We Help Long-Term Care Teams Stay Survey-Ready
We process and analyze inspection reports and plan of correction using AI to extract insights and trends so providers can improve care quality and stay ahead of compliance risks.