Failure to Keep Call Lights Within Reach for Dependent Residents
Penalty
Summary
The deficiency involves the facility’s failure to keep call lights within reach of residents in accordance with its Call Light and Accommodation of Needs policies. The policies require that when a resident is in bed or confined to a chair, the call light must be within easy reach, and that staff behaviors support residents in maintaining safe independent functioning and that individual needs and preferences are accommodated. The Director of Nursing confirmed that the facility should ensure call lights are always kept within residents’ reach. For one resident admitted with hemiplegia and hemiparesis following a cerebral infarction, generalized muscle weakness, and COPD, the care plan identified the resident as a fall risk and specified interventions to maintain the call light within reach and to place the call light and frequently used items within reach to improve functional ability in bed. The resident’s history and physical indicated capacity to understand and make decisions, and the MDS showed moderately impaired cognitive skills and dependence for multiple ADLs, including eating, toileting hygiene, bathing, dressing, and personal hygiene. During observation and interview, the resident was awake in bed with the call light hanging on the left bedrail and the call light pad hanging under the bed; the resident stated being barely able to move hands and arms and unable to reach the call light pad. A CNA confirmed during the same observation that the resident could not touch the call light pad under the bed and acknowledged staff should have placed it within reach. For another resident admitted with prostate cancer, secondary malignant neoplasm of bone, difficulty in walking, generalized muscle weakness, and type 2 DM, the care plan also directed staff to place the call light and frequently used items within reach to improve functional ability in bed and to maintain the call light within reach due to fall risk. The history and physical documented that this resident had capacity to understand and make decisions, and the MDS indicated intact cognitive skills, with partial/moderate assistance needed for toileting hygiene, bathing, and dressing, and supervision or touching assistance for eating, oral hygiene, and personal hygiene. During observation and interview, the resident was sitting on the left edge of the bed with feet on the floor, while the call light was on the floor on the opposite side of the bed; the resident stated being unable to use the call light because it could not be reached. An LVN present at the time confirmed the call light was on the floor on the other side of the bed and that the resident could not reach it, acknowledging staff should have kept it within reach.
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