Insufficient Nurse Staffing on Two LTC Facility Floors
Penalty
Summary
The facility failed to provide sufficient nursing staff, specifically Registered Nurses and Licensed Practical Nurses, to the third and fourth floors, which had the potential to affect 71 residents. On multiple occasions, only one nurse was assigned to each of these floors, with each nurse responsible for 35 to 38 residents per shift. Both nurses assigned to these floors reported feeling overwhelmed and unable to provide timely medication administration or adequate attention to all residents' needs. The nurses stated that while there were enough Certified Nursing Assistants (CNAs) present, the CNAs could not perform nursing duties, and the nurses were left to manage all clinical responsibilities alone. The staffing coordinator confirmed that the third and fourth floors were staffed with only one nurse per 12-hour shift, following instructions from the Director of Nursing (DON). The coordinator also reported that nurses had complained about the workload being too heavy for one nurse, but she was unable to make staffing changes herself. The DON acknowledged that the change to one nurse per floor was a recent decision and that nurses had previously expressed concerns about the workload, especially during the morning shift when medication passes and other activities were at their peak. The DON admitted to implementing the reduced nurse staffing schedule and recognized that the assignments were overwhelming for the nurses. She stated that she had previously tried the assignment herself and was able to complete the work, but acknowledged that the nurses' complaints indicated residents were not receiving the proper care. Review of staffing schedules and facility policy confirmed the reduction in nurse staffing and the facility's stated requirement to provide adequate staff to meet residents' needs.