Staffing Shortages Lead to Delayed Medication Administration
Penalty
Summary
The facility failed to ensure sufficient staffing levels to administer medications in a timely manner, as required by physician orders. This deficiency was identified during a complaint investigation for one of two residents reviewed for Activities of Daily Living (ADL). The report highlights that the facility did not meet the minimum staffing requirements set by New Jersey law, which mandates specific staff-to-resident ratios for different shifts. During the week of June 23 to June 29, 2024, the facility was found to be deficient in Certified Nurse Aide (CNA) staffing on several day shifts and in total staff on one evening shift. This staffing shortfall contributed to delays in medication administration for residents. The Medication Administration Audit Report (MAAR) for the same week revealed multiple instances of delayed medication administration. For example, on June 25, 2024, medications such as Quetiapine and Clonazepam were administered several hours later than scheduled. Similarly, on June 29, 2024, medications including Quetiapine, Fluoxetine, Macrobid, and Keppra were administered late. The Director of Nursing acknowledged that these delays were due to short staffing caused by a mass exit of staff. The facility's policies, including the Staffing Center Plan and Facility Assessment, were reviewed but did not provide further information on how staffing levels were determined to meet patient needs.
Plan Of Correction
1. Corrective Action of Areas Affected: The facility is scheduling sufficient staff in order to administer medications in a timely manner, and to meet staffing ratios. 2. Other Areas Affected: The Administrator reviewed CNA staffing ratio compliance from 12/3/24- 12/9/24 to determine if any other shifts did not meet minimum requirements. 3. Systemic Changes to Prevent Future Occurrences: The [R] has been re-educated on the staffing requirements and CNA ratios. 4. Monitoring of Corrective Action: A weekly audit will be conducted by the NHA/designee to determine if the CNA to resident ratio is being met for the next 30 days and verify that sufficient licensed staff were scheduled to administer medications timely. Results of the audit will be reported monthly to the Quality Assurance Improvement Plan Committee.