Insufficient Staffing Levels Compromise Resident Care
Penalty
Summary
The facility failed to provide sufficient nursing staff to meet the needs of all residents, as evidenced by multiple instances of inadequate staffing levels across various shifts. On one occasion, two CNAs called in for the evening shift, leaving only one LPN responsible for 30 residents. Recent staffing changes further reduced the number of CNAs and dietary aides scheduled per shift, resulting in only one CNA on duty during certain night shift hours, despite the facility's census and the high acuity of resident care needs. The facility's own assessment indicated a need for more staff than were actually scheduled, and the Director of Nursing and Assistant Director of Nursing were frequently required to work as floor nurses to cover gaps. Residents in the facility had significant care requirements, including 12 needing a Hoyer lift, 6 requiring two-person assistance for transfers, and several needing specialized dietary support or feeding assistance. The reduction in staffing led to delays in meal service, incomplete documentation by CNAs, and staff expressing concerns about their ability to provide adequate care. Staff interviews revealed that the changes were made due to perceived overstaffing and a stable census, but the result was increased dissatisfaction among staff, with some refusing to pick up extra shifts or complete required documentation as a form of protest. Multiple staff members, including the scheduler, dietary director, and CNAs, reported their concerns to management, noting that the new staffing levels were insufficient and created unsafe conditions for both residents and staff. The facility did not utilize agency staff to fill gaps, and the lack of adequate coverage was acknowledged by facility leadership. The surveyor also noted that the facility did not always have a second staff member with BLS certification available, despite many residents having full code status.