Nonfunctional Bathroom Call Lights for Multiple Residents
Penalty
Summary
The deficiency involves the facility’s failure to ensure that bathroom call lights were functional in three residents’ rooms, as required by facility policy. For one resident with CHF, chronic kidney disease, muscle weakness, and lack of coordination, records showed intact cognition and a need for maximal assistance with lower body dressing, moderate assistance with toileting hygiene, and supervision with toilet transfers. During observation with a CNA in this resident’s room, pulling the bathroom call light cord did not activate the call light indicator outside the room. The CNA reported that the resident had complained the previous day that the bathroom call light was not working, and that when the CNA checked it then, the light indicator flashed but there was no audible sound; the CNA could not recall if she had reported this malfunction to other staff. A second resident, admitted with peripheral vascular disease, myalgia, and muscle spasms, had intact cognition and required supervision for toileting hygiene and lower body dressing, and was always continent of bowel. During observation in this resident’s room, when the CNA activated the bathroom call light, the call light indicator outside the room did not activate. The CNA stated that the call light indicator was not functioning and that the resident would not be able to call for assistance from the bathroom. A third resident, with diagnoses including heart failure, anxiety disorder, muscle weakness, and left hip pain, had intact cognition and required moderate assistance with toileting hygiene and toilet transfers, and was always continent of bowel and bladder. During observation with the Environmental Director in this resident’s room, pulling the bathroom call light cord did not activate the call light indicator outside the room. In an interview, the Environmental Director stated there was no documented evidence that the call light system, including bathroom switches, was assessed for functionality, and reported there was a loose connection in the system wiring that potentially caused the malfunctioning bathroom call lights. The Environmental Director and the DON both stated that all resident rooms should have functioning call light systems and that failure to have functional bathroom call lights could potentially delay care and increase fall risk. Review of the facility’s policy on call lights indicated that the call system must be accessible at each toilet and bath or shower facility and that staff will report problems with call lights or the call system to the supervisor and/or maintenance director.
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