This regulation requires nursing facilities to maintain a functioning resident call system that allows residents to summon staff assistance from their bedside and from toilet and bathing facilities. The system must be operational at all times, accessible to residents who may be on the floor, and alternative communication aids must be available for residents with disabilities that prevent use of the standard system. Facilities must have processes to routinely verify system functionality and ensure continuity during power outages.
View official sourceF919 (Rev. 211; Issued: 02-03-23; Effective: 10-21-22; Implementation: 10-24-22) §483.90(g) Resident Call System The facility must be adequately equipped to allow residents to call for staff assistance through a communication system which relays the call directly to a staff member or to a centralized staff work area from– §483.90(g)(1) Each resident’s bedside; and §483.90(g)(2) Toilet and bathing facilities. INTENT: §483.90(g)(1) and (g)(2) The intent of this requirement is that residents, when in their rooms and toilet and bathing areas, have a means of directly contacting caregivers. In the case of an existing centralized nursing station, this communication may be through audible or visual signals and may include “wireless systems.” In those cases, in which a facility has moved to decentralized nurse/care team work areas, the intent may be met through other electronic systems that provide direct communication from the resident to the caregivers. GUIDANCE: §483.90(g)(1) and (g)(2) This requirement is met only if all portions of the system are functioning (e.g., system is not turned off at the nurses’ station, the volume too low to be heard, the light above a room or rooms is not working, no staff at nurses’ station), and calls are being answered. For wireless systems, compliance is met only if staff who answer resident calls have functioning devices in their possession and are answering resident calls. The call system must be accessible to residents while in their bed or other sleeping accommodations within the resident’s room. The call system must be accessible to the resident at each toilet and bath or shower facility. The call system should be accessible to a resident lying on the floor. POTENTIAL TAGS FOR ADDITIONAL INVESTIGATION Issues related to the timeliness of calls being answered should be referred to and examined for sufficient staffing under §483.35 Nursing Services. PROBES: §483.90(g)(1) and (g)(2) Is there a functioning communication system from rooms, at the bedside, toilets, and bathing facilities in which resident calls are received and answered by staff? Is the call system accessible if the resident were lying on the floor? If a resident has disabilities that make use of the facility’s communication system inaccessible, are alternatives, auxiliary aids, or services available to meet this requirement and to meet the resident’s needs as identified in the resident’s assessment or plan of care? Residents and their representatives should be interviewed about whether calls are being answered. • Has the call system been in need of repair recently? If yes, ask: o What did the facility do if the call system was not working? o How many times was the call system non-functional/not operating? o Were any needed repairs made timely? o How long was the call system non-functional/not operating? Does the facility have process to routinely ensure the call system for residents is operational? During a loss of power, will the resident call system be operational or is an alternate means of communicating with the staff put into place?