Failure to Maintain Minimum CNA Staffing Levels on Multiple Shifts
Penalty
Summary
The facility failed to consistently provide sufficient certified nurse aide (CNA) staffing to meet the needs of residents on the first floor, as determined by its own facility assessment and staffing grid. Review of daily staffing schedules for July and August 2024 revealed multiple shifts where CNA staffing fell below the minimum levels established by the facility, including instances where only two or three CNAs were present during day and evening shifts, and occasions with only one or no CNAs on night shifts. These staffing levels did not align with the provider average ratio levels required for the unit, which called for five CNAs on day shift, four on evening shift, and two on night shift. The facility's policy states that adequate staffing must be maintained to meet resident care needs as outlined in their comprehensive care plans. Interviews with the Administrator and Human Resources Director confirmed that staffing had been an issue in the past, with reliance on agency staff to cover callouts and a history of insufficient CNA numbers. The Human Resources Director acknowledged the use of a staffing application and a weekly scheduling process, but records showed that actual staffing often did not meet the established minimums. The Administrator provided documentation confirming the required staffing ratios, which were not consistently met during the reviewed period.