Failure to Maintain Sufficient Nursing Staff for Timely Resident Care
Penalty
Summary
The facility failed to maintain sufficient nursing staff to meet the needs of all residents in a timely manner, as evidenced by multiple interviews and record reviews. The census at the time was 37 residents, with several requiring substantial or maximal assistance for activities of daily living (ADLs), including toileting and incontinence care. One resident with significant medical conditions, including respiratory failure, heart failure, and morbid obesity, reported waiting up to 45 minutes for assistance after activating the call light, particularly during evening and overnight shifts. This resident also stated that CNA hours had been reduced on his unit, leading to frequent delays in receiving help, especially when left on the toilet. Staff interviews corroborated these delays, with CNAs and LPNs reporting that call lights often went unanswered for extended periods due to insufficient staffing. Staff described situations where only one CNA was available per unit or for the entire building, making it difficult to provide timely care, especially for residents requiring two-person assistance. Staff also reported that when short-staffed, essential care such as toileting, incontinence care, showers, and vital signs were delayed. The ombudsman and other residents confirmed ongoing concerns about untimely responses to call lights, particularly during evening and night shifts. Administrative staff acknowledged awareness of staffing shortages but indicated that efforts to fill shifts were sometimes unsuccessful, and administrative personnel did not always come in to assist when notified of shortages. The facility's own policy requires sufficient licensed and unlicensed nursing staff on each shift to meet residents' needs, but interviews and documentation revealed that this standard was not consistently met. The deficiency affected the ability to provide timely and adequate care to all residents, as reported by both staff and residents.