Failure to Respond Timely to Resident Call Lights
Penalty
Summary
Surveyors identified a deficiency related to untimely response to resident call lights, resulting in delays in care for multiple residents. One resident with chronic kidney disease (stage four), esophageal obstruction, and hypertensive heart disease, who was cognitively intact and had no behavioral issues, activated his call light because he was cold. Observation showed the call light was activated at 11:12 A.M. and not answered until 11:39 A.M., a 27‑minute delay. A CNA stated that call lights should ideally be answered within seven to eight minutes. Another cognitively intact resident with progressive multiple sclerosis, emphysema, neuromuscular bladder dysfunction, and an above‑knee amputation reported having to wait longer than an hour on multiple occasions for call lights to be answered, causing delays in care. A third resident with moderately impaired cognition, nontraumatic intracerebral hemorrhage, type II diabetes mellitus, atrial fibrillation, hypertension, and total bowel and bladder incontinence, along with his wife, reported sometimes waiting an hour or more for call light response; prior care conference documentation showed the family had voiced concerns about nurses not responding, leading the resident to call out for help. A staff member reported receiving complaints from residents about long call light response times and personally observing call lights unanswered for 25 to 35 minutes. The DON stated the facility does not perform call light audits or know the average response time, and the President of Clinical Services RN reported the facility has no standard for call light response times, only an ideal of under 20 minutes.
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