Untimely Call Light Responses for Dependent Residents
Penalty
Summary
The deficiency involves the facility’s failure to respond to resident call lights within the 15-minute timeframe required by its April 2019 Call Light Response policy, which directs staff to answer call lights within 15 minutes and to receive notifications via door lights, a call light panel at the nurse’s station, or handheld electronic devices. For one resident with intact cognition, heart failure, a history of falls with fractures, and an ADL self-care performance deficit, the MDS and care plan documented the need for substantial assistance with showers, hygiene, toileting, and transfers using a standing mechanical lift, as well as use of a wheelchair and positioning bar. This resident reported that staff did not respond to her call light within 15 minutes and that she timed responses, noting that about four to five times per week it took staff a long time to answer. An electronic call light log showed that on one occasion her call light, activated at 1:30 PM, was not answered for 27 minutes and 21 seconds. Another cognitively intact resident with bilateral leg impairment, wheelchair use, dependence on staff for toileting and hygiene, frequent urinary incontinence, and diagnoses including carotid stenosis, dysthymic disorder, and breast cancer, also had an ADL self-care performance deficit care plan requiring a standing mechanical lift transfer to the commode with one staff, assistance with repositioning, moderate assistance for dressing, and total dependence for bathing. This resident stated that staff did not always answer her call light within 15 minutes and that when this occurred, she used her cell phone to call the nurses’ desk for assistance, and she felt the facility was short staffed and used a lot of agency staff. Electronic call light audit data for this resident showed multiple delayed responses: one call answered 44 minutes and 50 seconds after activation, another answered 1 hour and 2 minutes after activation, and another answered 27 minutes and 21 seconds after activation. The DON reported she was not aware residents complained about untimely call light responses, believed corporate call light audits were in the “green zone” indicating calls were answered within 15 minutes, and acknowledged only a few family complaints at care conferences that she felt had been addressed.
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