Insufficient Nursing Staff and Suspension of Restorative Nursing Program
Penalty
Summary
The facility failed to provide sufficient qualified nursing staff to meet the needs of all residents, as evidenced by both direct resident interviews and review of facility records. Multiple residents reported long wait times for assistance, particularly during nighttime and meal times, with some residents waiting over an hour for help with toileting and repositioning. Resident council meeting minutes and interviews consistently documented complaints about delayed call light responses and unmet care needs. Staff interviews confirmed that staffing shortages were ongoing, with restorative nursing aides being reassigned to direct care duties, resulting in the suspension of the Restorative Nursing Program (RNP). Record reviews for specific residents revealed that care plans and therapy recommendations for restorative nursing services, such as range of motion and splint application, were not being followed due to lack of available staff. For example, one resident's therapy discharge recommendations for nightly range of motion and stretching prior to splint application were not completed, and another resident's care-planned restorative programs were not occurring. Staff interviews further confirmed that the facility had only one restorative aide, who was consistently assigned to floor duties instead of restorative care, and that efforts to restart the restorative program were hindered by ongoing staffing shortages. The facility assessment did not address staffing needs specific to the resident population and acuity, contributing to the inability to provide required care and services. Staff and administration acknowledged the challenges in hiring and training restorative nursing aides and the impact of staff reassignments on resident care. The lack of adequate staffing led to delays in essential care, such as repositioning, toileting, and restorative services, as well as diminished quality of life for residents, as directly reported by both residents and staff.