Inadequate Staffing Levels on Unit A
Penalty
Summary
The facility failed to ensure sufficient nursing staffing to meet the needs of residents on Unit A, as determined by their own nursing coverage plan. The facility's policy outlined a staffing plan to provide necessary services, but the actual staffing levels fell short of these guidelines. The staffing schedules for May, June, and July 2024 revealed that the number of Certified Nursing Assistants (CNAs) on various shifts was consistently below the required levels. Interviews with staff, including CNAs and the Director of Nursing, confirmed that the facility often operated with fewer CNAs than needed, leading to inadequate care for residents who required total care. Interviews with CNAs highlighted the challenges faced due to insufficient staffing. CNAs reported that they were often required to care for more residents than the staffing plan allowed, with some shifts having only two CNAs for a unit of 41 residents. This situation was exacerbated on weekends when staffing levels were particularly low. CNAs expressed frustration that despite raising concerns with administration, no effective measures were taken to address the staffing shortages. The facility's reluctance to use agency staff further compounded the issue, as agency staff were sometimes turned away despite the need for additional help. The Director of Nursing acknowledged the staffing issues and stated that efforts were being made to hire more staff and reduce reliance on agency workers. However, the staffing coordinator indicated that the facility was expected to use ideal staffing levels rather than minimal ones, which were not being met. Despite claims of improvement, the facility's staffing levels remained inadequate, impacting the quality of care provided to residents on Unit A.
Plan Of Correction
Plan of Correction: Approved January 14, 2025 The Staffing Coordinator/designees will schedule sufficient staffing on all units and all shifts. The facility assessment was reviewed and updated to show current staffing resources. Plan for Monitoring Corrective Action: The facility has implemented a bi-weekly staffing meeting to go over new hires, retention, recruitment, incentives, and all other related staffing issues. The final staffing schedule will be reviewed on a weekly basis by the staffing coordinator/DON, and findings presented to the bi-weekly staffing meeting. The facility will seek additional contracts from staffing agencies as a staffing contingency plan. We will increase the frequency of our orientation to facilitate a quicker onboarding process, thereby increasing our staffing resources. Our facility assessment will be reviewed and updated annually or as needed to show current staffing resources. All findings from the bi-weekly staffing meeting will be monitored by the QAPI monthly x 6 by the staffing coordinator/designee.