Deficiency Due to Insufficient Nursing Staff on Resident Unit
Penalty
Summary
The facility failed to provide sufficient nursing staff to meet the needs of residents, particularly on Unit 2, as identified during a recertification survey. Payroll-Based Journal Staffing Data for the specified quarter showed excessively low weekend staffing, and a review of staffing schedules revealed that the number of Certified Nursing Assistants (CNAs) assigned to Unit 2 frequently fell below the facility's own stated par levels. The Facility Assessment indicated that five CNAs were required for a full census of 39 residents during the day shift, but staffing records showed that only three or four CNAs were often scheduled, even when the census was in the mid-30s. The facility did not update its Facility Assessment to reflect actual census or acuity changes and did not implement new interventions despite being aware of low weekend staffing triggers. Two residents in the Resident Council reported concerns about short staffing, especially on weekends, stating that delayed responses to call bells sometimes lasted up to an hour and affected their care. Anonymous nursing staff also expressed that insufficient staffing led to overwhelming workloads, prioritization of certain residents over others, and the need to stay beyond their shifts to complete care tasks. These staff members indicated that the number of residents assigned per CNA was often too high, impacting the timeliness and quality of care provided. Interviews with facility leadership, including the Administrator, Staffing Coordinator, and Director of Nursing Services, revealed a lack of consensus on staffing adequacy. While the Staffing Coordinator and Director of Nursing Services stated that four CNAs were sufficient for the census levels observed, this contradicted the Facility Assessment and staff feedback. The Administrator acknowledged the discrepancy between the Facility Assessment and actual staffing but maintained that the assessment was only a suggestion and not a requirement. No new measures were taken to address the identified low weekend staffing.