Insufficient Nursing Staff Affects Resident Schedules
Penalty
Summary
The facility was found to have insufficient nursing staff to meet the residents' schedules for activities of daily living, specifically for two residents who were reviewed for concerns regarding resident choices. Resident 66 was observed in bed at 9:13 AM, although he preferred to be out of bed by 6:30 AM. He stated that his ability to get out of bed depended on the number of nurse aides available. Similarly, Resident 25 was assisted out of bed at 8:00 AM, despite her preference to be up by 6:30 AM to avoid eating breakfast in bed, which she dislikes due to the risk of dropping food. An interview with a nurse aide, Employee 11, confirmed that the delay in assisting Residents 66 and 25 was due to only three nurse aides being assigned to the unit at the time. The following day, with four nurse aides on duty, residents were able to follow their preferred schedules. These concerns were discussed with the Nursing Home Administrator and the Director of Nursing, highlighting the facility's failure to provide sufficient nursing staff to meet the residents' needs and preferences.
Plan Of Correction
The facility is unable to retroactively ensure sufficient staffing to meet the immediate needs of residents 66 and 25, but was able to provide appropriate assistance later that same morning. A 2-week look back will be conducted of the facilities' staffing to identify trends and an appropriate intervention to ensure sufficient staffing in the facility. Education will be provided to the facility scheduler and RN supervisors on ensuring sufficient staffing. Measures will be put in place to adequately provide staff. These measures include continuing our retention committee, increased advertising efforts, utilization of agency staff, and sign on bonuses. The Director of Nursing/designee will educate ppd staffing levels to RN Supervisors, HR, and the nursing scheduler who are responsible to maintain adequate staffing ratios. The DON or designee will complete audits x5 a week x 8 weeks to ensure that the facility maintains sufficient staffing. Weekly staffing reviews will occur between the DON and Administrator. The results of the audits will be reviewed at the facilities QAPI meeting for recommendations. The performance reviews for employees 8 and 9 were completed. All employees eligible for an annual performance review received one. Education was provided to the facility DON to ensure the completion of annual performance reviews. The Administrator or designee will conduct weekly audits x 12 weeks to ensure that eligible employees receive a performance review. The results of the audits will be reviewed at the facilities QAPI meeting for recommendations.