This is an archived article that was published on sltrib.com in 2008, and information in the article may be outdated. It is provided only for personal research purposes and may not be reprinted.
Editor's note: This story originally ran in June.
Next to every bed and bathroom in every nursing home is a little red button. When pushed, an alarm sounds at the nurse's desk and a light flashes over the bedroom door.
These call lights are how the frail and elderly summon for urgent help. But all too often, caretakers are slow to respond, if they respond at all.
A Salt Lake Tribune examination shows that state inspectors have cited nearly one-third of Utah's nursing homes for a call light violation in the past two years.
At the Hurricane Rehabilitation Center, the call lights didn't work in 10 rooms.
At the Bear River Valley Care Center, a man confined to a wheelchair waited 25 minutes for help getting into bed. "Sometimes it takes half a day," he told regulators.
At the Willow Wood Care Center, a woman pushed her call light to get pain medication. She received her pills three hours later.
A slow response to a call light not only can impact a person's medical care, but also steal their dignity. In a number of cases, people waited so long for help that they ended up soiling themselves.
Utah inspectors receive more complaints about call lights than anything else, said Greg Bateman, who heads the state certification team.
"We are certainly sensitive to it," he said. "It is pretty much the first line of defense a resident has."
Often, call light problems are a symptom of inadequate staffing. But with a nursing shortage in Utah and throughout the nation, it is a problem that just about every nursing home fights.
"Let's face it, the first place people look for work is not at a nursing home," said Dirk Anjewierden IV, who leads the Utah Health Care Association, an industry group. "It does come down to staffing for so many of these things."
Because caretakers usually respond faster when they know inspectors are watching, Bateman said he often relies on resident complaints to identify a problem. There is no hard and fast guideline for responding to a call light, but state regulators want to see someone at least assess the person's needs within the first five minutes.
That is too rigid, said Galen Ewer, administrator at Christus St. Joseph Villa in Salt Lake City.
"Setting a five-minute criteria doesn't take into consideration the human factors that come up at times," he said. If multiple residents need help at the same time, as one example, someone may have to wait.
Ewer and other nursing home operators also complain that some of the call light violations are erroneous. They responded within five minutes, but the resident thought it took longer.
"If you decide you want something and you don't have anything else to do, a wait can seem like an eternity," Ewer said.
Advocates for the Disability Law Center keep track of this problem.
"We have some cases where a client pushes the button and because someone doesn't teleport into the room immediately, they were complaining," said Eileen Maloney, who is a member of the center's abuse and neglect team. "But I don't think that is a majority."
She said she visits some homes where call lights are constantly ringing and staff members ignore them.
"The problem is, it's a he said, she said thing," said Anjewierden. He believes some of the call light violations are not justified, but nursing homes have no way to refute the claims of upset residents.
At least not yet.
The industry is teaming with state inspectors to create a new incentive program next year that will encourage nursing homes to replace their old call light system with the latest technology.
The state has a standard quality incentive program where homes get some extra money if they identify their own problems and solve them. In the last few years, the state added a second program to offset the costs of major upgrades, such as new air conditioning or electronic medical records.
In 2009, nursing homes will be able to get some state help to purchase portable call lights that don't rely on overhead paging.
"The systems we've got are old and somewhat antiquated," said Anjewierden. "It rings right to the nursing station. If everyone is out, no one is around to hear it."
The new system would send the call for help to something akin to a pager that each nursing aide would carry. The state is also exploring a device that would allow residents to call for help wherever they are, not just their bed and bathroom.
And here is the part that Anjewierden really likes: The system would allow homes to document response times, providing proof that either resident complaints are valid or not.
"I don't know where the truth lies, but this is going to define it for us," he said.
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