Failure to Keep Call Light Within Reach and Respond Timely for Dependent Resident
Penalty
Summary
The deficiency involves the facility’s failure to ensure a resident’s call light was accessible and that call lights were answered in a timely manner, as required by facility policy. The resident was an older adult admitted for a femoral neck fracture and right hip pain following hip replacement surgery, with intact cognition and a perfect BIMS score of 15. She required substantial or maximal assistance for bed mobility and transfers and did not ambulate, leaving her dependent on staff for in-bed needs. During an observation, the resident reported that she could not get out of bed and relied on staff, but stated that it often took staff about three hours to respond to her call light. She further stated that her call light was usually not attached where she could reach it, and during the surveyor’s visit, both the resident and the surveyor had to look for the call light, which was found on the floor approximately 2 to 3 meters away from her. The resident described remaining in wet incontinence briefs for three hours while waiting for assistance. In a subsequent observation, a CNA was seen exiting the resident’s room while the call light remained on the floor and out of the resident’s reach. When questioned in the hallway, the CNA initially stated that the resident could use the call light and that it was within reach, but upon re-entering the room, the CNA found the call light on the floor, picked it up, and clipped it to the resident’s linen, then acknowledged that the call light had not been reachable and needed to be clipped to the resident’s gown, clothing, or linen to be accessible. The DON later stated that nursing staff are required to ensure that call lights are always within reach so staff can attend to residents’ needs. The facility’s written “Answering the Call Light” policy, dated 12/2017, requires that when a resident is in bed or confined to a chair, the call light must be within reach and that call lights should be answered as soon as possible. These observations and interviews demonstrate that staff did not follow the facility’s call light policy for this resident.
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