Failure to Provide Sufficient 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 care and unmet resident needs. Multiple residents reported waiting 30 minutes or longer for assistance, with some instances of waiting up to two hours, particularly during weekend shifts. Residents with significant medical needs, such as those with multiple sclerosis, dysphagia, cancer with a laryngectomy stoma, PEG tube, cerebral infarction, peripheral vascular disease, depression, and Parkinson's disease, experienced delays in care, including assistance with turning, repositioning, and toileting. One resident reported having to attempt unsafe self-transfers due to long wait times, and another reported holding her bowels as long as possible because of the delays. Observations and interviews confirmed that call bells were not answered in a timely manner, and staff acknowledged being unable to respond promptly due to insufficient staffing. One nurse aide stated that only two staff were assigned to a hallway where many residents required two-person assistance, making it difficult to meet residents' needs. Documentation showed that a resident received fewer showers than desired, with staff citing lack of staffing as the reason for substituting bed baths for showers. Group interviews with residents further corroborated the ongoing issues with delayed responses and inadequate care provision. A review of nurse staffing data revealed that the facility did not meet state minimum requirements for nurse aide and nurse staff direct care hours on at least one shift. The Nursing Home Administrator confirmed the failure to meet these requirements and acknowledged the facility's responsibility to provide sufficient nursing staff. The administrator was unable to explain the ongoing reports of untimely staff responses or the specific observed delay in responding to a resident's call bell.