Failure to Provide Adequate Staffing for Resident ADL Needs
Penalty
Summary
The facility failed to provide adequate nursing staff to meet the Activities of Daily Living (ADL) needs of residents, as evidenced by multiple resident complaints and staff admissions. During a Resident Council meeting, all sixteen residents present unanimously reported a shortage of staff, resulting in delayed call light responses, missed showers, and untimely incontinence care. Residents described waiting extended periods—sometimes up to two hours—for assistance, with some staff turning off call lights without providing the requested help or telling residents to wait until the next shift for care. Several residents reported having to wait so long for assistance that they experienced incontinence or had to seek help at the nurse station themselves. Interviews with residents further corroborated these issues, with consistent reports of insufficient staff, poor attitudes among aides, and a lack of empathy. Residents described staff as being overworked, with some aides refusing to adjust their routines to meet residents' immediate needs. Night shift staffing was particularly problematic, with reports of residents not receiving water, being left unattended for long periods, and staff failing to return after initially responding to call lights. Some residents also noted that showers were infrequent and dependent on which aide was working, and that some aides were not adequately trained to provide proper shower care. Staff interviews and facility records confirmed the staffing challenges. The staff scheduler acknowledged frequent call-ins and an inability to secure adequate coverage, as the facility does not use agency staff and relies solely on internal staff. The Nursing Home Administrator admitted to ongoing staff turnover and issues with staff performance, including some staff hiding or not doing their work. The facility's call light audits only tracked response times, not whether the requested service was actually provided. Observations by the surveyor also noted staff complaints about being short-staffed. The facility's own policies and job descriptions require sufficient staffing and competency in ADL care, but these standards were not being met, as evidenced by the consistent resident and staff reports.