Insufficient Kitchen Staffing and Inappropriate Use of CNAs
Penalty
Summary
The facility failed to provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service on four out of eight days reviewed. Observations and punch detail reports showed that on multiple occasions, only one cook and one dietary aide were present for meal shifts, and certified nursing assistants (CNAs) were pulled from their regular assignments to assist in the kitchen. Staff interviews confirmed that it was common for the kitchen to be understaffed, resulting in delays in meal service, use of disposable serving ware due to lack of dishwashing support, and CNAs being reassigned without coverage for their original duties. The interim Food Services Manager was unsure about the adequacy of kitchen staffing, and the Staffing Coordinator acknowledged that CNAs had to fill in for kitchen staff, though she claimed it was not frequent. Further interviews revealed that when CNAs were moved to the kitchen, their floor assignments were not always covered, leading to missed resident care tasks such as showers. The Nursing Home Administrator stated that the Dietary Manager was responsible for kitchen staffing and that CNAs were not given additional training when assisting in the kitchen, as their duties were limited to tray service. Facility policy required ongoing monitoring and evaluation of staffing adequacy, but the documented practices and staff statements indicated that these procedures were not consistently followed, resulting in insufficient kitchen staffing and disruption of both dietary and resident care services.