Failure to Maintain Sufficient Nursing Staff and Timely Care
Penalty
Summary
The facility failed to provide a sufficient number of Licensed Nursing Assistants (LNAs) and Registered Nurses (RNs) to meet the needs of its residents, as required by regulations and the facility's own assessment. The Assistant Director of Nursing (ADON) reported frequently working overtime to provide RN coverage and being one of only two staff members trained to draw blood, resulting in 30 outstanding lab orders that had not been processed over a two-week period. Record reviews revealed extensive missed and late medication administrations, with 2,177 pages of missed medications and treatments and 6,017 pages of late administered medications and treatments. The Director of Nursing (DON) confirmed that these medications and treatments were not administered according to prescriber orders or facility policy. A traveling LPN reported that medication passes were consistently late due to insufficient staffing and frequent interruptions to assist residents. The facility's Hours Per Patient Day (PPD) report showed that staffing levels were below the minimum required for both LNAs and overall direct care for 6 out of 10 sampled weeks. The Administrator stated that requests for additional staff from corporate were unsuccessful, as the internal agency staffing group could not provide RN staff and the company would only use this internal agency. This deficiency was noted as a repeat issue from a previous recertification survey.