Prolonged Call Bell Response Times Undermining Resident Dignity
Penalty
Summary
The deficiency involves the facility’s failure to honor residents’ rights to dignity and timely response to needs, particularly regarding call bell response times. Facility policies stated that residents had a right to a dignified existence and that staff were expected to respond to call bells within 10–15 minutes, with response to resident needs taking priority over routine tasks and being the responsibility of all staff regardless of role or assignment. During a confidential group meeting, all 13 of 13 residents present reported experiencing long call bell response times. Review of the call bell monitor at the nurses’ station showed multiple instances of prolonged unanswered call lights, including one resident’s call bell on for 70 minutes, another resident’s call bell on for 39 minutes, another for 36 minutes, and another for 40 minutes. Further observations and interviews detailed a specific incident involving one resident whose call bell remained on for extended periods while their toileting needs were not promptly met. On one occasion, the call bell monitor showed this resident’s call bell active for 70 minutes before a CNA briefly entered, turned off the call bell, and left, stating the resident wanted their table moved and to get up and that they would inform the assigned aide. The resident later reported believing their light had been on for about an hour and that they needed to use the bathroom. The call bell was reactivated, and a medical secretary subsequently entered, turned off the call bell, and exited without meeting the resident’s stated need, after which the call bell was again turned on until staff eventually assisted the resident to the bathroom. Staff interviews confirmed that all staff were responsible for answering call bells, that expected response times were 5–15 minutes, and that wait times of 30 minutes or more were considered excessive. A clinical coordinator acknowledged having seen long wait times on the call bell monitor in the past and agreed that 40- and 70-minute waits were excessive and that no one should wait that long.
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