Prolonged Call Light Response Times Lead to Delayed ADL Assistance
Penalty
Summary
The deficiency involves the facility’s failure to ensure that residents who are unable to carry out activities of daily living received timely assistance to maintain grooming and personal hygiene, as evidenced by prolonged call light response times. The facility uses a call light system that sends alarms to mini mobile devices on each resident floor, with no central hub or visual/audible indicators outside resident rooms. Staff reported that there are supposed to be four mobile devices per floor for the scheduled CNAs, but some devices are missing, leaving only two on the third floor. One CNA stated that staff often leave a device in the central nursing area and only check it when they have time, and that many call lights are not answered timely or at all because CNAs do not hear the alarms and are too busy to check the devices. Another CNA reported receiving daily complaints from residents about long call light wait times and attributed these complaints to the lack of mobile devices. The call light log reviewed by the surveyor showed active and resolved alarms with the length of time taken to respond. Multiple cognitively intact residents reported extended waits for assistance with care after activating their call lights, and the call light log corroborated long response times. One resident reported waiting up to 45 minutes, with the log showing a wait of 1 hour and 32 minutes; another reported similar delays, and a third resident stated he had waited over an hour and a half, with the log showing a 1 hour and 34 minute wait. Another resident described waiting up to 4 hours and sometimes receiving no response at all, with the log showing a 1 hour and 10 minute wait. An additional resident stated she frequently waited over an hour, with documentation of a 2 hour and 36 minute delay, and another resident reported waiting over 2 hours, with the log showing a 50 minute wait. The Nursing Home Administrator acknowledged that the call light system is new, that it had experienced problems related to the facility’s wireless internet, and that each of the four CNAs per floor should have a device. The administrator was unaware that some mobile devices were missing and stated that call lights could possibly go unanswered if CNAs are not properly notified.
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