How long should it take someone to answer the nurse call button in a NH?

Well, "best practices" for me would be one heckofa lot sooner than an hour, I'll tell you that much. Thirty minutes to answer a call button is terrible, in my opinion. Someone's fallen. Thirty minutes for help to peek in the door? I don't THINK so.

Now, I can see a nursing home having a policy that allows them great flexibility in getting someone into bed . . . maybe a certain time they start doing it so they can rally the troops . . . IF it was explained to me that it WAS because of procedure.

But thirty minutes to answer a call button? That's deplorable.

I applaud you for logging this information. And, tell you what, you've got a whole lot more patience than I do. I'd go out in the hallway and waylay an aid in ten minutes or less. At least when I was in the building and dad used his call button, I wouldn't hesitate to be a verrrry squeaky wheel.

There are a number of nurses on board here. Perhaps they can give you the answer to best practices.

In my mother's NH sometimes residents stay in the dining room after a meal to have more coffee and visit. There is a difference between staying the dining room and being left in the dining room. Can you be sure of which this is?

Could it be that since this is repeated every night, the staff "knows" that the call is about putting Dad in bed, and that just doesn't have the urgency of all those residents getting done with their dinners and out of the dining room? Does it also take this long for an "unscheduled" call in the middle of the afternoon? Because a half hour is TOO LONG by anyone's best practices or standards. I can understand the delay once they find out that Dad is fine and just needs help getting to bed, but that initial delay concerns me.

Who have you talked to so far at the NH about this? The nurse who is usually assigned to him on that shift? The Director of Nursing? The Administrator? I think that is the order of contacting them. Also be sure to attend the care conferences for your Dad and bring it up there. But start with his "usual" nurse and see if you can get an explanation and better yet improvement.

I wonder if this repeated request could simply go into his care schedule? That this resident needs to be helped to bed at 6:15 pm (or whenever), and no call would be necessary.

I too am curious about what the "expected" response time is to call buttons.

Call button complaints are number one on the hit parade. Even with a good staff ratio of 1:6, it can take two hours to bed everyone down. I try to tell mom that when the aide is there to help her get her stockings on in the morning, don't ask her to come back later, because it will take a long long time.
Ask for a scheduled time and try to be first on the list.

I just finished up a case with a patient in a NH. It was one of the finest if not the finest facility I have ever been in. Because I was private duty, per the facility's policy, I was not to transfer my patient. Only staff could do that. I was there on a regular basis to assess her and to make sure she was getting everything she needed from the NH and from her caregivers. The family hired me.

A half hour call light time sounds like a luxury to me. I'd use the call light and someone would come in after 30 minutes or so and turn the call light off and leave the room and it was anyone's guess as to when someone would come back.

The staff ratio was 1:13 and if any resident needed anything during the dinner hour it was tough luck because the aides were in the dining room feeding patients who couldn't feed themselves. I knew better than to use the call light during the dinner hour. Sometimes my patient would mess herself waiting for help until the dinner hour was over.

I was told by an aide when I was allowed to use the call light and when I was not allowed to use the call light.

I wasn't there very long on days when I would go and assess this patient but I was there enough to see how things were done. I made meticulous documentation and stayed in touch with the family. I would speak to the family after my assessments and if I let them know what I saw was objectionable the family would high-tail it up there to see what was going on. I can't tell you how many times that happened.

The relationship between private duty and regular staff in a nursing home is very poor. Private duty antagonizes staff for some reason. Keep that in mind if you have private caregivers with your loved one in a NH.

No matter how nice the facility is it's still institutional living and your loved one is always just one among many. I can't tell you the horrors I saw in this lovely, expensive nursing home and it chilled me enough that I may never do private duty nursing in a facility again. The unprofessionalism of most of the staff, the way the staff treated my patient (with me standing right there!) among many other things I won't go into here. My dad was in a nursing home and now I have to wonder if he received this kind of treatment? He was on hospice but he wasn't supervised 24/7? Did the NH treat my dad this way?? Anyway, I had to submit my documentation to my nurse manager and seeing it there, documented day after day after day, she was aghast at how my patient had been treated and she set up a meeting with the facility based on my documentation, which are considered legal documents.

Anyway, nothing would surprise me at this point and based on my own professional experiences I would say 30 minutes is d*mn fast.

(Sorry I ranted. This subject really sets me off.)

My dad went into a Nursing home for rehab after being in the hospital, we as a family having always heard horror stories about nursing homes demanded that we be allowed to stay with him 24/7. He needed more care that we knew they would give him. He had had radiation in his head and neck so as a result his mouth was so dry and we had a rinse that we gave him every few hours to help with the dryness. We knew they would not give him the rinse so the only way he would get it is if we were there to give it to him. One day my 89 yr old mom was with him and he had to go to the bathroom, mom helped him into the bathroom and when he was done he asked her to press the call button so someone could come and help him, she pressed it, no one came so she went to the desk and they were all sitting around talking and laughing, they told her they would be right there but again no one came, she went to the desk again and was told they were on their way but of course no one came so after 45 minutes my mother helped dad off the toilet. They never did any physical therapy with him, they wrote him off as soon as he came through the door. maybe us being there bothered him but we were not going to leave him there to fend for himself. All of us saw horrible things, people are ignored, not just my dad. They know who has family who is involved in the care and who has no one looking out for them, those poor people are left in dirty diapers for hours, they are not stimulated at all and no one gives them the love and care they deserve. We took dad out of the nursing home after 2 weeks and brought him home where he passed away 2 weeks later. For those 2 weeks though dad was taken care of the way every elderly person deserves to be cared for. There may be some really good nursign homes out there but I have never heard a good story about any of them. It so unfortunate to because there comes a point in families where the only choice is to put the loved one in a nursing home, families do it with the hope that their loved one will get the care they deserve but in most cases they do not and its very sad.

I am an RN and a Regional nurse consultant. I have worked in long term care since 1994 and have been in more facilities than I can count. I have been there all hours of the day and night and often am in an office where I can see and here most things going on. Many of the aids on the floor have done the job for many years also and they are in the trenchs every day doing a dirty and un appreciated job. There are a few who have become so jaded in their work that they no longer get enjoyment from it and do this simply because they dont know what else to do. When I see this I encourage them to find something else. I see staff show lack of compassion and consideration to the residents, Ive never myself visually observed deliberate abuse. Ive overheard some insensitive statements made to family and residents but no physical abuse from staff, not saying it may not happen. I have though seen and heard many abuses from familly and residents toward these staff members who have the hardest job in the facility. Ive seen staff hit, kicked, cussed, called stupid, spit on, etc. Ive see family members be unrealistic in there family members care and be so rude and hateful to staff that they leave in tears swearing never to do this job again. Overall I see more abuse toward staff that anything and most of them are paid minimum wage and work two jobs to make it.
There can be some consideration on both sides, believe me, the better you treat staff and thank them for the care and help the more they will respond and try to please it is so nice to be treated kindly for a change.
There are times 2 staff members are assigned to 30 residents to clean, bathe, shower, feed, etc. Then you get an admission that the family is feeling a lot of guilt for not being able to take them home and take care of them and having to rely on a facility and strangers that they have unrealistic expectations and time seems longer than it its. They will turn on a call light for family to be assisted to bed and no one comes, more that likely you will not see one of them in the hallway, you may find them in a room helping get someone off the floor who had fallen, they may be feeding someone or something. In all the homes I have been to you would not find an administrator or DON or floor nurse who would not respond and investigate the issue. Sometimes actions are taken from the investigation that all are not aware of if they determine an infraction was done.

Sad but the problem is lack of staff, just like hospitals. Profits, not getting payment by Medicaid, all of these things are what is part of the problem with our medical system.

My daughter is a ICU trauma nurse. Because of patient surveys that have to be competed for Medicare and Medicaid to pay the hospital, many hospitals are not getting paid for Medicare patients as they should. Why? These surveys have to meet 100% satisfaction. Impossible with short staffs.

One of the problems patients complained of in my daughter's ICU unit was the alarms going of for patients who code. Or in other words are dying. So her hospital turned them down to satisfy patients. The result? Two deaths in the past two weeks due to no one hearing the code. Why do this? To satisfy patients in order to get a good survey results.

What does this have to do with nursing homes? Like hospitals all are for profit. Even if they say they are not. So there are less employees doing work for more people with less pay. And they say it will get worse in the future.

My experience as a patient in two local hospitals has been excellent in call answering department but in the infection control area there was often a lot to be desired. As a nurse myself, now retired I have also been guilty of these sins myself. I worked on-call for hospice and when I entered a home in crisis I am afraid I went to the patient's bedside to provide comfort rather than ask the caregiver where I could wash my hands. Sometimes patients and families felt I did not respond quickly enough to their requests but here I have to use that over used term TRIAGE. This is some thing that all staff have to do on a daily basis. They often know their patients needs very well and anticipate their call is not urgent. This is not right and should not happen but when they have a patient walking down the corridor trailing diarrhea behind them they have dealt with the thing that seems the most urgent. What I would want to see happen is for bells to be answered within 5 minutes and for some one to explain why a request can't be met immediately and give a time frame in which they would be free to comply with the request. I would also like to see patients and families told on admission and frequently reminded when it is a good time to help with certain activities. For example maybe the gentleman who likes to watch the news after dinner could be put to bed before dinner and eat his meal in bed.
As far as the aides and nurses are concerned I feel their pain and I am sure home caregivers share their difficulties. Often there will be one trained nurse on a floor of 24 patients and all her time is taken up with giving medications.
The nurses and aides all have lives outside of nursing and their pay is far from optimal. The nurse that works overnight may have to rush home to get the children ready for school and do whatever needs to be done in the home. Then she has maybe six hours to sleep if she is lucky before the kids get home. the result is she goes to work very tired and does not work at a very fast speed. Some of the aides in particular are much older, overweight and have many disabilities. they really should not even be working but they have to survive. They may be divorced and are too young to retire. They may also not qualify for health care and can not afford needed medications or have treatments that would make life easier.
The real question is not how long it should take for a call button to be answered but there needs major system changes that regretfully we are unlikely to see in this financially driven environment. Becoming a nurses' aide is one of the easiest and cheapest trainings to get. The training is often offered free to people willing to work in a nursing home and in any event only takes five weeks So you see why call buttons take so long to be answered.

Thank you everyone for pouring your hearts out in these posts. I can certainly hear the frustration. I don't think it's a party issue, I think both Republicans and Democrats are money driven. I think it's our entire society that's money driven. I completely understand that the staff where my dad is are doing the best they can with what they have. Several are very friendly and genuinely caring. But in my opinion, there just isn't enough staff to be responsive to everyone's needs. The patients are fed dinner around 5 and finish around 6, my dad being one of the last ones to finish. Then I take him for a walk (push him in the wheel chair), either outside if the weather is nice or around the halls to read the people's names on the doors or look at the pictures on the walls, etc. I do this to give him some social stimulation. So by the time we get back to his room, it's between 6:30 and 7:00. I don't think that the call button is not being answered because people are busy cleaning the dining room, I really think they are just spread too thin. I'm beginning to think that my best bet is to find out their pattern of when they put everyone to bed and jump on that schedule. But from what I've seen over a period of two months is that there is no schedule. It's more of a catch as catch can routine, or in other words, the dog with the loudest bark gets the bone. My sister doesn't work outside the home, so she's there during the day and has had many, many discussions with the social worker there. The answer is always the same, "I'll look into that, I'll make a change, I'll blah, blah, blah. Nothing changes. This is why we are both documenting his care, or the lack thereof. I feel so bad for those patients who don't have family check on them. Because the care I see when we are right there with him pretty much every day leaves a lot to be desired. I can only imagine the care he would get if we weren't there. For now, I'm concentrating on just documenting the violations of the nursing home standards, as set forth by our Texas Dept. of the Aging. I just wanted to make sure that I wasn't expecting more than I should as far as the response time. And although it sounds as if everyone agrees that an hour is too long to wait, I agree that a part of the delay is that they know it's not an emergency. You guys have given me some really good feedback and solutions. I greatly appreciate it.

When my MIL was in rehab, weekends were the worst. Not enough staff, one weekend there were two young men for 30 pts... plan your potty breaks! And my MIL is not someone who takes to young foreign men.. if you get my drift..LOL I can;t blame them, they were doing thier best.
And I have noticed the whole bring up the score thing at the hospital I work at.. much worse with the new regs in the last 2 years . we are expected to act like 4 star hotels! familys expect better care than they want for the patient ( free food, drinks delivered) But my Mom had great care in rehab.. a smaller place than MIL, with a long time staff and perhaps we had more charged to her insurance.. but it was worth it. She paid in for years,, time to collect

family advocacy is definately important . a lady at my aunts nh has toenails about 1/2 an inch long and are beginning to turn into rounded claws . very painful without a doubt . i thought my caregiving days were over when aunt went into nh . not at all . her personal and emotional comfort are still very much reliant on myself and pia ..
id suggest everyone be respectful of staff and plan your work with the loved one so its an asset to staff as opposed to a hinderance or a source of friction ..

A call to the Department of Disabilities and Aging will open a case against the nursing home and it will be investigated. My father was in a nursing home (against my wishes) and he assured me it would be OK for my husband and I to travel and see his parents. We were gone 1 week when my Dad called me at 4:30 am to tell me he hadn't been fed and to come and get him. I jumped into clothes and was on a plane home by 7:30 am. I got to the NH and he looked great. Clean linens...sitting up in bed. But he was very distraught. Let me stress the word 'looked'. Looks as they say are deceiving. I saw first that his bedside tray was pushed up against the wall and some type of liquid was in Saran Wrapped covered cups...the call button was on the bedside table out of reach...my Dad told me the man vacuuming the carpet gave him the phone so he could call me. I pulled back the covers to help my Dad move to his wheelchair and that is when I flipped shit. He had a skin tear on his elbow that had been weeping for so long that there was a 21 inch circumference dried stain on the sheet. His IV was infiltrated and his leg swollen...why they had a SQ IV is beyond me. His Foley catheter was taped to his leg with silk tape and had caused a stage 2 ulcer. The catheter upon entry was crusted and his penis bleeding. I had my camera and began taking photographs. I then found the RN in charge and asked her when did she last assess him? She lied and I let her have it. The social service coordinator threatened to call security...I begged her to call the police because I was filing charges against them. I pulled one of the elder abuse pamphlets from the holder on the wall and called right then. I demanded my father be taken to a hospital and in all my 30 plus years in nursing...I've never seen a transfer happen so quickly. I was thankful...so was my Dad. I can talk about it now without crying...it's only taken 3 years to get past it. I couldn't imagine anyone treating my Dad that way. I wanted to kill them. DADS took the complaint and they investigated the NH in record time...I received a letter about a month later thanking me for reporting...that they found multiple residents in the same or worse shape and that they implemented strong fines and stipulations in order for the NH to stay in business. This was in Texas as well.

Capt FYI it is against the law at least in NYS for anyone but a Podiatrist to cut patients toe nails. Fingernails are OK. they should have a podiatrist comimg in. Nothing to stop a relative doing it. As you know with your POA you probably are not allowed to so keep Edna's feet under the covers for her pedicures!!!!!!!!!!!!

My mother cannot use the call button. She don't know how or what it is, she has dementia. So I have told the staff in the NH that when she yells for "Help" or screams out "Come Here" she is wanting to go to the restroom or wants water. I have just this past week got a copy of the nurses progress report and have noticed on several occasions my mother has called out for help and the RN gave her Ativan ( an anxiety pill.) The staff was told not to give Ativan to her until they called me. I live 2 minutes away! I am very upset at this time over my findings and due to my mother was diagnosed with shingles and was put into a molded/mildew room for isolation and I found out that my mother also has a sprained waist that she didn't have when she arrived there in July of this year. I am using my right as POA and will be getting copies of all my mother's reports come tomorrow. I am at home stressed out due all this happening this past week. BAD, BAD, BAD nursing home!

Veronica91, I don't know about NYS, but that is not the case everywhere! Nurses can cut toenails, for example. (RN may be required for diabetic patient.) My Mom's NH has a podiatrist come in and we have him do it for her, but before that a visiting nurse did it for her.

Jeannie it is definitely the case in NYS. I would highly recomment that podiatrist do the cutting if there has been long neglect because they have the proper tools including grinders etc to deal with the long curled over ones

It seems pretty universal. I got my CNA certification so I could learn more to care for my mother-in-law. I can echo the horror stories of care, neglect and verbally abusive treatment of residents. I was mortified. I couldn't sleep when I got home. Two of the aides I worked with were wonderful and answered the call lights really quickly. They new their residents and their needs. But others were horrible, beds made that were soil with feces and urine. Cold showers. No hand washing.

But I can tell you that the residents that had families that visited, that complained and check on things, you were told to make sure you did this or that because the family would be there.

I never, ever want to see my loved ones in a nursing home after the things I witnessed. But I understand that the aides are overworked, underpaid and treated like second class citizens. They aren't given enough time to do a good job. It is horrible for all… maybe except the people making the profit.

Is there no law out there with a specific time?

I cannot vision our Federal or State governments spending months in committee meeting, using taxpayers money, to decide to put a law in place as to what would be the longest wait for a call button in a care center. Then what? Arrest the Aide or Nurse for not coming within the time frame?

There are patients who over use the call button because they want attention. We could bring our love ones home and we hire our own nursing staff, but I bet call buttons or bells rung wouldn't get immediate attention, either.

Is there no law out there with a specific time?

Bring in the Ombudsman. I'm an Ombudsman and when they see me coming, no call light goes longer than 30 seconds. I find that very amusing because I know it's a total fantasy.

Tell those halfwits at the NH either to get their act together or you will pull your father out of their nursing home and find him another place for him to go! What was just mentioned makes no sense at all, and I don't care if anybody's busy or not!

My parent has had the unfortunate experience of being in multiple nursing homes for one reason or another. Three of these nursing homes sent my parent home with UTI which caused weakness and falls; the outcome was more injuries and back to the hospital and then another nursing facility. Several times it took 4 hours to get someone to answer a call light and other times it was 45 minutes or more. The particular Nursing home now being used is owned by a multi-millionaire who bought a mansion on an island and was putting in a tram system, security tower, new road etc. My parent has suffered from multiple sores and family is the one to find them, not staff. When staff is questioned each and every one says they don't know about it. As for food, you know d*mn good and well that the owner is eating far better than the people he claims he cares for. My parent has been fed two pieces of plain bread with that processed plastic cheese. Yum, how appetizing for dinner. A jet black grilled cheese sandwich, Vegetable soup with three pieces of vegetable, broccoli beef soup with one piece of each in it, dessert is a 1.5" x 1.5" piece of dry crumbly cake and to cheap to add frosting. Dry as a bone chicken breast rolled in corn flakes, dry as a bone pork loin roll in rice krispies - too cheap to buy seasoned bread crumbs. Burritos that are hard on the ends, vegetables are either way overcooked or undercooked to where residents can't chew. Nursing Homes in Oregon that accept Medicare and Medicaid are the "Ghetto's" of elder living. We invited Gov. Kate Brown to lunch to taste the lovely food here and no response. Our congress doesn't care about the elderly. Let me tell you, saying please and thank you and bringing in treats to staff still don't get your family members any better care. You can document, document, and document until you your fingers are ready to fall off. By the time the State Ombudsman office investigates it is 3-6 months later and 98% of neglect claims end up being unfounded with investigators stating if they don't see if happen then it didn't happen or the offending staff or witnesses have already moved on. You can take photos hundreds and hundreds of photos and the State will not use them in determining abuse or neglect. they cite the fact that you can't prove who is in the photo. Well, who else's buttock are we taking photos of? And how many elderly people can put there legs over their heads to their fact is in the photo to prove who it is? Between Medicare and Medicaid these h*ll holes get around $9,000 per month to neglect family members. how about paying family $5,000 per month to stay home and take care of our elderly? I will end my life before I end up in one of these h*ll holes.

When my grandma was in rehab, it took them forever. I'm talking hours to come and help her. She was on a hoyer or I would have taken her home and I could hear the staff outside her door debating on who wanted to go deal with the hoyer machine to take her to the bathroom. In fact on several occasions, which I'd complain about, she would push the call button. Within minutes someone would come turn the thing off, then they wouldn't return until I would go chase them down and force their hand to take her to hte bathroom. Then they would always come in and ask her if she needed to go to the bathroom or would be ok with just a quick change. She always would hold it and require a real trip to the bathroom instead of just a change due to them taking hours to get to her. She came home of course with an untreated UTI/Bladder infection. I found the time they would come terrible and I took her back home as soon as she was in a walking boot because I'd rather die caring for her than have the end of her life spent sitting in a room and as she has repeated on several occasions when she is reminded of being back there, "No one comes for me. No one cares about me. I sit here and wait and wait and no one comes." No one young or old should ever be made to feel that way and with her having dementia having her have that happen so many times that I had to convince her by repeating over and over again I will always come when she calls, before she started to call out again instead of withdrawing thinking no one will come for her.

My grandma came home with untreated pneumonia, a pressure sore on her leg from someone placing a piece of toilet paper down her cast (it couldn't have been grandma as a long object longer than anything in her room had to be used and she had no working bathroom in her room which didn't matter as she was on strict hoyer while there so should have never been left alone in the bathroom to have that happen), and had lost 30 pounds due to not eating because they would place the food on her tray leaving her sleeping and then take it away before she even woke up. She would wake up a half hour to an hour later and be hungry but no one would offer food. She was a diabetic so of course she would drop in sugar so she would pass out and be found who knows how long later in a diabetic coma and they would call the primary care doctor asking for an upper to bring her back. Then later on they would offer her chocolate cake and candy when she was hungry instead of a meal and would once again have to call the doctor (same day often enough) asking for something to lower her blood sugar. Needless to say, her leg did not heal until I had her home with me eating balance meals, going to the bathroom when asked and walking on her walking boot instead of being stuck in a wheelchair (they had everyone in the entire building in a wheelchair even if you were told you could and should walk).

She also had a huge open wound on her back that they didn't even tell me about and on her bottom which I'm guessing was from falling from her wheelchair. They had the nerve to laugh about it when grandma would tell me about it (she would tell me she was sore and body parts hurt) and say that she fell out of her wheelchair again. They would also brush it off saying nothing hurt. I asked to be called when that happened and no one would. I didn't find it funny and let me tell you I was downright pissed when I saw she actually had marks on her back and bottom from sliding out of the wheelchair. I was able to repair them with duoderm but one was so badly infected it really hurt her at first. I felt so bad!

I hate the idea of nursing homes and honestly pray with all my heart I'm dead before ever seeing the age I'd be put into one.

I don't care if anybody's busy here; I would push that call button and tell the nurse get here right this minute! I got up right in one nurse's face a long time ago because my mother wanted a drink of water and the nurses took their good old time getting my mother a drink so I ended up doing it. I also don't care if it violated protocol. Some of these hospitals can take their protocol and stick it up their rear!

As a former nurse in a long term care facility, if my aides did not answer a call light within 5 minutes to at least see what was needed and ask for help if busy, I would have had a fit. I recently had a problem with the facility my MIL was in. She had COPD and started exhibiting signs and symptoms of upper respiratory infection. The nurses and PA waited until she went into respiratory distress to send her to the ER. She died less than a week later. Her left lung was so full it collapsed. The day before they sent her out my husband asked the PA to send her out and she told him that her chest X-ray was clear and she was waiting for blood work to come back. If she had been my patient she would have gone out days before whether the PA approved or not. If you feel that your family member is not getting adequate care stand up and say something. You are their only defense against abuse and neglect.

Well to be honest, what you observed is the real deal in almost all nursing home facilities. Staffing is ridiculous, managements are lunatics. If you can do a research on who own these NHs? Mostly Jewish people. Facilities are saturated with high acuity patients such as bed bounds, risk for falls, psych probs, agitated/violence, multiple comorbidities with short staffing! An example, 1 nurse:50 residents ratio. Imagine to give medications to 50 residents with different time administrations plus have to deal with wound dressings, call bells, family complaints, rude doctors, uncooperative nursing assistants?! The problem lies on the management/owners that cutting off workers to get more profits. It is actually a hideous way to abuse health care laborers. Mostly Nurses that graduated in U.S. refused or i should say have a choice to find a decent place to work; such as hospitals. If you asked them why? They’re just gonna say, “ Nursing homes? Oh hell no!” Because of this, the managements/owners are forced to recruit nurses from developing countries. These recruited nurses/ health care providers are getting underpaid and overworked in exchanged getting visas/green cards, along with their immediate families. Nursing homes are BS! Unfortunately, many put their families inside so they don’t need to deal with them that much; convenience i guess. Actually, It’s like putting your love ones to rot. Patients are soaked with feces/urine that causes open sores that lead to ulcers then later to infection to sepsis to death! I can go on and on and on.

When my husband was in the hospital, they enforced a “No-pass” zone. No matter what staff member was passing by the room, if the light was on, they stopped in the room. At one point, it was a person from the financial department. If she could not help, she found someone who could. His rehab was the same way. However, the second rehab he was in, he was left on the toilet for over an hour and sat there for so long,when they got him into the lift to get him back into bed, he passed out and fell off the lift. My MIL was left to lay in feces for over an hour once in her facility.

I have never seen the staff at a facility of any kind sitting behind the desk doing crossword puzzles or eating yogurt and energy bars while call lights flashed up and down the halls. If a call light goes unanswered for a while, I’ve seen staff in other rooms tending to other patient’s needs. It takes me 15 minutes to change my husband. The process in the facility was the same. No patient or resident has any higher standing than any other. It’s not fair to blame an overworked staff for not falling over themselves to refill a glass of ice water.

If calls consistently go unanswered for too long, perhaps a word in the ear of the DON?