Failure to Ensure Resident Dignity, Respect, and Timely Call Light Response
Penalty
Summary
The deficiency involves failures to ensure residents were treated with dignity and respect, including honoring their right to request assistance and to be spoken to respectfully. One cognitively intact female resident with diabetes and hypertension reported that during a night shift she rang her call light for help to use the bathroom, but the CNA who responded initially stated she was not going to help and left the room. The CNA later returned, assisted the resident to the bathroom, and instructed her to use the call light when finished. After returning the resident to bed, the CNA told her not to press the call light for the rest of the night. The facility’s own incident and complaint reports documented the resident’s allegation that the CNA told her she could not assist at that moment, later assisted her, and then told her not to press the call light again. Another cognitively intact resident with multiple significant diagnoses, including acute respiratory failure, chronic kidney disease, type II diabetes, morbid obesity, COPD, difficulty in walking, and a care plan requiring two-person assistance for toileting, reported she became incontinent of bowel after waiting for her call light to be answered the previous night. When staff finally responded, the CNA told her, “you stink,” and the resident reported that such treatment made her feel like she did not mean anything. During a confidential group meeting with eight residents, all participants reported that agency staff often stood at the nurses’ station talking loudly and “goofing around,” did not follow facility protocol, and were rude and disrespectful. Residents reported agency staff answering call lights by saying, “your light’s on, what do you want,” shutting off call lights without returning, long call light response times (up to an hour) on nights with primarily agency staff, and late medication administration. Five of the eight residents also reported that staff allowed doors to slam at night, which they found terrifying. These events occurred despite a facility policy stating residents have the right to a dignified existence, self-determination, and communication.
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