Delayed Call Light Response and Inadequate Nursing Staff Responsiveness
Penalty
Summary
Surveyors identified a deficiency related to inadequate nursing staff response to resident call lights, resulting in delays beyond the facility’s own expectation of a 15-minute response time. One resident with a BIMS score of 15 and documented as always incontinent of urine and bowels reported that it frequently took longer than 15 minutes for staff to answer call lights, occurring on both shifts. Continuous observation by surveyors showed a call light in the East hallway remained unanswered for 16 minutes. Another resident, also cognitively intact with a BIMS score of 15 and diagnoses including renal insufficiency, neurogenic bladder, and paraplegia, reported having his call light on while waiting to lie down and stated he had been waiting about 20 minutes, noting that such delays occurred from time to time. During a resident council meeting with multiple residents, participants reported that call lights could take longer than 15 minutes to be answered, particularly at most shift changes. The DON stated her expectation was that call lights be answered within 15 minutes or less. Review of the facility’s policy on call lights indicated that all staff members who see or hear an activated call light are responsible for responding. Despite this policy and stated expectations, surveyor observations, resident interviews, and documentation review showed that call lights were not consistently answered in a timely manner, contributing to the identified deficiency in providing adequate nursing staff response to meet residents’ needs.
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