F0558

E

Failure to Ensure Timely Response to Call Lights for Residents Requiring Assistance

North Huntingdon, Pennsylvania Survey Completed on 03-11-2026

Penalty

No penalty information released

Summary

The deficiency involves the facility’s failure to ensure call lights were accessible and answered in a timely manner for multiple residents who required staff assistance, particularly with toileting and transfers. Facility policy on call bells dated 4/1/25 required staff to respond to resident requests and needs when using the call bell system and, when answering from the nurse’s station, to ensure staff respond to resident requests immediately. Despite this policy, resident interviews, clinical record reviews, and resident council minutes documented repeated delays in call light responses and concerns about accessibility and timeliness.

Resident R1, admitted 6/8/25 with diagnoses including adjustment disorder, diabetes mellitus, and hypertension and a BIMS score of 12, required supervision or touching assistance for toileting hygiene and substantial/maximal assistance for toilet transfers. R1 reported using the call light for help and stated it took a half hour or more, sometimes more than an hour, to receive assistance. Resident R2, admitted 7/22/24 with hypertensive chronic kidney disease, adjustment disorder, and hypertension and a BIMS of 15, required partial/moderate assistance with toileting hygiene and was unable to perform toilet transfers due to medical condition; R2 stated it took a half hour and sometimes much longer to get help after using the call light. Resident R3, with osteomyelitis of the vertebra, bipolar disorder, and hypertension and a BIMS of 15, required partial/moderate assistance with toileting hygiene and toilet transfers and reported that call light responses took at least thirty minutes, citing one instance of waiting from 11:45 a.m. to 1:15 p.m.

Resident R4, admitted 5/4/21 with COPD, diabetes mellitus, and depression and a BIMS of 15, required partial/moderate assistance with toileting hygiene and supervision or touching assistance for toilet transfers and stated that after using the call light, there was always a wait, sometimes thirty minutes and other times much longer. Resident R5, admitted 4/3/25 with traumatic brain injury, end-stage renal disease, and diabetes mellitus and a BIMS of 15, was dependent for toileting hygiene and toilet transfers and had filed a grievance on 12/31/25 documenting hours of waiting for a brief change after calling for assistance. Resident R6, admitted 2/15/26 with hypertension, heart failure, COPD, and a BIMS of 11, required substantial/maximal assistance with toileting hygiene and toilet transfers and reported always having to wait for help and having called 911 on occasion when the wait was too long. Resident council minutes from two separate meetings documented that call bells were not being answered in a timely fashion, and in an interview, the Nursing Home Director and DON confirmed the facility failed to ensure call lights were accessible and answered promptly, in violation of 28 Pa. Code 211.10(c)(d), 211.12(d)(1)(2)(3)(5), and 201.29(i)(o).