Insufficient Nursing Staff Resulting in Delayed Resident Care
Penalty
Summary
The facility failed to provide sufficient nursing staff to meet the needs of residents, resulting in delayed responses to call lights and unmet care needs for multiple residents. Certified Nurse Aides (CNAs) reported being assigned up to 16 or more residents per shift, with their ability to keep up with care dependent on resident acuity. Several residents reported waiting 30 to 60 minutes or longer for staff assistance, particularly for pain medication and call light responses. One resident, who had a history of spinal fusion and was dependent on renal dialysis, reported multiple instances of waiting 45 minutes or more for pain medication, and another resident described similar delays during overnight hours. Residents also reported that delays in care negatively impacted their physical therapy progress and caused concerns about timely assistance during emergencies. Staff interviews corroborated these concerns, with CNAs and LPNs stating that the facility was understaffed and that it was difficult to find assistance for two-person transfers. CNAs reported being unable to take breaks due to staffing shortages and described being responsible for up to 30 residents when coworkers were unavailable. Some staff admitted to instructing residents to use the bathroom in their briefs as a time-saving measure. Residents and staff consistently reported that call light response times were inadequate, and these issues were repeatedly raised in Resident Council meetings without resolution.