Insufficient Nursing Staff to Meet Resident Needs
Penalty
Summary
The facility failed to provide sufficient nursing staff to meet the needs of all residents, as required by their own Facility Assessment and staffing policy. Review of staffing schedules over a two-month period revealed multiple instances across all three shifts and units where the number of certified nurse aides (CNAs) fell below the facility's minimum requirements. Staff interviews confirmed that callouts were frequent, and the facility did not utilize agency staff, relying instead on internal pools and offering bonuses to cover gaps. Despite these efforts, there were repeated occasions when units operated with fewer CNAs than needed, particularly on weekends and during evening shifts. Staff reported having to work double shifts, skip breaks, and work into the next shift to complete resident care tasks, with some units experiencing only one CNA on duty at times. Resident acuity data indicated a high number of residents requiring extensive assistance, including mechanical lifts, help with eating, and total or extensive assistance with toileting. Staff consistently reported that the workload was heavy and that the reduction in CNA staffing from four to three per unit made it difficult to complete all required cares. Staff also noted that tasks were rushed, and resident care was sometimes incomplete, especially when callouts reduced staffing below even the minimum guideline. Supervisory staff acknowledged that low staffing levels could negatively affect resident care and that complaints about staffing had been raised by both staff and residents. Resident Council meeting minutes documented ongoing concerns from residents about delayed call bell responses, insufficient assistance with activities of daily living, and staff inattentiveness, particularly on weekends. These concerns were raised repeatedly over several months, with no documented evidence that the facility addressed or responded to them. During interviews, residents confirmed that they had to wait a long time for care and that their concerns about staffing had been expressed in previous meetings. The Administrator acknowledged awareness of these concerns and stated that incentives were offered to attract and retain staff.