Insufficient Nursing Staff Resulting in Delayed Resident Care
Penalty
Summary
The facility failed to provide sufficient nursing staff to meet the needs of all residents, as evidenced by multiple resident and staff interviews, as well as a review of staffing schedules. Several residents reported significant delays in receiving assistance, particularly with call light responses and help with activities of daily living such as toileting and mobility. One resident described waiting five to six minutes for bathroom assistance and an additional ten minutes after finishing, while another reported waiting up to an hour and a half for help after experiencing bowel incontinence. A third resident indicated that assistance was sometimes unavailable during the midnight shift, with call light response times ranging from immediate to as long as three hours, especially in the evenings. Staff interviews corroborated these accounts, with CNAs reporting that the second floor, housing approximately 34 residents, was often staffed with only one or two CNAs during certain shifts, particularly overnight. Staff noted that when nurses assisted with resident care, they were better able to meet resident needs, but agency nurses typically did not help CNAs. There were also instances where CNAs were required to assist with meal service due to dietary staff shortages, further reducing their ability to provide direct care. Staffing schedules confirmed that on multiple occasions, only one CNA was assigned to care for an entire floor during overnight shifts, and that ideal staffing levels were not consistently maintained. Additional staff interviews highlighted that inadequate staffing was a persistent issue, especially on weekends, with only two CNAs assigned to entire units. This resulted in critical care activities, such as turning and repositioning residents and performing daily hygiene routines, not being completed as required by residents' care plans. The combination of low staffing levels and additional non-nursing duties prevented staff from delivering care in accordance with established care plans, directly contributing to the deficiency.