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F0725
E

Insufficient Staffing and Delayed Call Bell Response

Flourtown, Pennsylvania Survey Completed on 04-25-2025

Penalty

No penalty information released
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The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.

Summary

The facility failed to provide sufficient nursing staff to meet the care needs of its residents, as evidenced by the delayed response to call bells and inadequate staffing levels. During a resident council meeting, several residents reported that call bells were not answered promptly, and staff would turn off the call bells without providing the necessary assistance. Specifically, Resident R29, who is non-verbal and communicates through head nods and facial expressions, was observed pressing the call bell to request a transfer to her wheelchair. Although a licensed nurse responded to the call, the nurse did not assist with the transfer and instead turned off the call bell, leaving the resident's need unmet. It was only after a surveyor's intervention that the resident was eventually transferred to her wheelchair. The facility also failed to maintain the state-required minimum staffing levels, as evidenced by the review of nursing care staffing levels. The facility did not meet the required minimum number of care hours per patient per day on several occasions and failed to meet the minimum nurse aide staffing ratios on multiple days. Interviews with staff, including the staffing coordinator, confirmed that the facility was consistently understaffed, which contributed to the inability to meet residents' needs in a timely manner.

Plan Of Correction

A - N/A B - Staffing Coordinator will staff the daily nursing staff to meet the required CNA to resident ratio of 1:10 on 7-3, 1:11 on 3-11, and 1:15 on 11-7. C - NHA, DON, and Staffing Coordinator educated on minimum staff to resident ratio. D - Weekly x4 then monthly x2 random audits by DON or designee of CNA staff ratio on 50% of days to ensure compliance with ratios.

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