Inaccurate Daily Nurse Staffing Documentation
Penalty
Summary
The facility failed to ensure that daily nurse staffing sheets accurately reflected the nursing staff who worked for 32 out of 72 days reviewed. Record review showed discrepancies between the time clock reports and the posted daily nurse staffing sheets. For multiple dates, staff who had clocked in and worked specific shifts, including RNs, LPNs, and CNAs, were not accurately recorded on the corresponding staffing sheets for those shifts. In several instances, staff worked overnight or across shifts, but their presence was not reflected on the staffing documentation for the relevant shifts or days. The daily nurse staffing sheets were designed to capture the name of the unit, resident census for each shift, and the number and hours worked for RNs, LPNs, and CNAs for each 8-hour shift. However, the review found that the sheets often underreported the actual number of staff present, sometimes omitting entire shifts or misrepresenting the number of staff on duty. For example, there were cases where LPNs or RNs worked night shifts, but the staffing sheets indicated no such staff were present. Similarly, CNAs who worked full or partial shifts were not always listed, or the number of CNAs was inaccurately reported. Interviews with facility staff revealed that the process for updating and posting the daily nurse staffing sheets had changed over time. Initially, the former receptionist was responsible for updating the sheets, but this responsibility later shifted to the Health Services Coordinator. At the time of the survey, the Administrative Assistant was being trained to take over this task. Despite these changes, the staffing sheets were not consistently updated to reflect the actual staff who worked each shift, leading to the identified deficiencies.