Failure to Accurately Post Daily Nurse Staffing Information
Penalty
Summary
The facility failed to ensure accurate and updated daily nursing staff postings for 24 out of 154 days reviewed. On multiple occasions, the hours worked by the DON and ADON, both Registered Nurses (RNs), were not included in the daily postings unless they were directly administering medications, despite their presence for at least 8 consecutive hours. Additionally, there were discrepancies between the posted RN and CNA hours and the actual hours recorded in employee time sheets, resulting in underreporting or omission of staff hours on several days. The resident census was also omitted from the daily postings on several dates, and on one occasion, the posted staffing information was outdated and did not reflect the current date or staff on duty. Interviews with the Regional Clinical Manager and Administrator revealed a lack of awareness that DON, ADON, or Unit Supervisor RN hours should be included in the daily postings when no other RN was scheduled. Furthermore, nurses on duty were not informed or trained to update the daily nursing staff postings in the absence of the Regional Clinical Manager, leading to missed or inaccurate postings. The Administrator confirmed that the daily postings should be completed daily and accurately reflect staffing for each shift, including the resident census.