Delayed Response to Call Lights for Resident Care Needs
Penalty
Summary
The deficiency involves the facility’s failure to ensure residents’ call lights were answered in a timely manner, resulting in delays in assistance for two residents. Resident 1 was admitted with diagnoses including sequelae of nontraumatic intracerebral hemorrhage, diabetes mellitus, and generalized weakness, and was documented as alert and oriented with intact cognitive skills but requiring maximum assistance for all ADLs and being frequently incontinent of bowel and bladder. According to the resident’s family member, on one occasion when Resident 1 experienced an episode of vomiting, the resident pressed the call light multiple times to request assistance, but no staff responded for 30 to 60 minutes. Resident 3 was admitted with a right femur neck fracture, generalized muscle weakness, and dysphagia, and had the capacity to understand and make decisions, with the MDS later indicating moderately impaired cognitive skills for daily decisions, maximum assistance needs for toileting and showering, and frequent bowel and bladder incontinence. Resident 3 reported that on the evening shift, staff sometimes took a long time to respond to the call light for incontinent care, and if no one answered, the resident would call a family member to request help. The family member confirmed that the resident often called in the evening when call lights were not answered for incontinence care, prompting the family member to call the facility to ask staff to change the resident’s incontinent brief. The DON acknowledged that delays in responding to call lights can delay meeting residents’ needs and can possibly cause skin breakdown such as pressure ulcers. The facility’s policy on the resident call system stated that the facility is adequately equipped to allow residents to call for staff assistance through a communication system relaying calls directly to staff or a centralized work area from residents’ bedside, floor, or toileting facilities.
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