Staffing Shortages Impact Resident Care
Penalty
Summary
The facility failed to ensure sufficient nursing staff to meet the needs of residents, as evidenced by a review of staffing schedules and interviews conducted during a recertification and abbreviated survey. The staffing schedule from December 22, 2024, through January 29, 2025, revealed that the facility did not consistently provide adequate staffing on all units and shifts. The facility's policy on nursing staffing, which was reviewed in September 2024, required an adequate number of staff consistent with the organization's mission and the population served. However, the facility did not meet its minimum staffing requirements on numerous occasions across various units and shifts. Interviews with residents and staff highlighted the impact of staffing shortages on resident care. One resident reported inconsistent wound care due to insufficient nursing staff, while another resident experienced delays in call bell response and toileting assistance, attributing these issues to short staffing. The staffing coordinator acknowledged the challenges in meeting minimum staffing requirements, citing staff call-outs and a high turnover rate, particularly among registered nurses, as primary barriers. Despite efforts to use temporary staffing agencies and offer incentives for extra shifts, the facility struggled to maintain adequate staffing levels. The Director of Nursing and the Administrator both confirmed the facility's difficulties in meeting staffing requirements. The Director of Nursing noted that temporary agency staff were used to fill gaps, but cancellations and retirements among permanent staff exacerbated the issue. The Administrator expressed concern over longer call bell response times due to short staffing, although they emphasized the staff's commitment to providing quality care. The facility's inability to consistently meet staffing requirements affected the timely delivery of care and resident well-being.
Plan Of Correction
Plan of Correction: Approved March 10, 2025 1. The specific description of the action/activities to be taken in order to achieve correction for the residents found to have been affected by the deficient practice. The staffing schedules were reviewed to identify whether or not any units were adversely affected by the nursing staffing. There was no issue with worsening of wounds or care not provided to any residents. RN Supervisor or designee would ensure all care was provided. 2. How will The New Jewish Home Sarah Neuman identify other residents having the potential to be affected by the same deficient practice (and implementation of action as in #1 above). The Facility acknowledges that all residents have the potential to be affected by this practice. Nursing and the HR team will work collaboratively to improve recruitment and retention efforts which may involve offering incentives, agency staffing, and utilizing overtime. 3. What measures will be put into place or systemic changes made to ensure the deficient practice will not recur. We will continue to work collaboratively with area nursing schools and C.N.A programs to improve our recruitment efforts. In 2024 we hired 140 direct care givers; 82% were from Agencies. In 2025 we plan on having an open house, as well as expand our relationship with other staffing agencies. The nursing staffing policy will be updated by DON or designee to reflect minimum and maximum staffing numbers for each unit that supports resident safety. The Recruitment Manager and Nursing Leadership team will meet weekly to discuss vacancies and recruitment efforts. The recruitment manager/HR will provide an update on positions filled and pending applicants for onboarding. The Recruitment Manager and/or designee will track and trend recruitment efforts and present the data monthly. The Nursing staffing policy will be updated to reflect minimum and full complement staffing. 4. How will The New Jewish Home Sarah Neuman monitor its corrective action to ensure the deficient practice being corrected will not recur (i.e. - what program will monitor the continued effectiveness of the systemic change). Nursing staffing hours/numbers will be monitored daily by the DON and reported to the administrator. The DON and/or designee will submit data reports on the vacancy/position report and recruitment and retention activities monthly to the QAPI committee.