Failure to Provide Adaptive Call Light for Cognitively Impaired Resident
Penalty
Summary
The deficiency involves the facility’s failure to reasonably accommodate a resident’s need for an appropriate adaptive call light despite the resident’s inability to use the standard push-button call light. The resident was admitted with multiple diagnoses including cognitive communication deficit, history of TIA, adult failure to thrive, and dementia, and had an Annual MDS assessment showing a BIMS score of 5, indicating severe cognitive impairment. A Social Services progress note documented that the resident used her call light appropriately to make needs and preferences known. However, during surveyor observation, the resident was found in her room with a distinct odor of stool and brown stool leaking from the left side of her incontinence brief. When asked how long she had been soiled, the resident stated she did not know, and when asked if she had used her call light to ask for help, she did not respond and shrugged her shoulders. Later that afternoon, a CNA entered the resident’s room and provided incontinence care. When interviewed, the CNA stated the resident was able to use the call light. Surveyors then asked the CNA to have the resident demonstrate how to use the call light. The resident smiled at the CNA and the surveyors but did not use the call light. When surveyors instructed the CNA not to point to the call light and the CNA again asked the resident to use it, the resident continued to smile without activating the device. These observations and interviews showed that the resident was not effectively able to use the standard push-button call light and had not been provided with an appropriate adaptive call light to accommodate her needs and preferences.
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