Insufficient Nursing Staff Fails to Meet Resident Care Needs
Penalty
Summary
The facility failed to provide sufficient nursing staff to meet the needs of all residents, as required by state regulations and the facility's own policies. Documentation showed that on multiple days, the number of licensed nurse and certified nurse aide hours per resident per day fell below the mandated minimums. For example, on several dates, the facility did not meet the required 1.1 hours per resident per day for licensed nurses and 2.2 hours for certified nurse aides, based on the resident census. The facility assessment and staffing policies indicated that staffing should be based on individualized resident needs, but actual staffing levels did not meet these requirements. Interviews with residents revealed that they experienced significant delays in having their call lights answered, sometimes waiting over an hour or up to three hours for assistance, particularly during the second and third shifts and on weekends. Some residents reported having to use the bathroom unassisted to avoid accidents due to these delays. Staff interviews corroborated these concerns, with certified nurse aides and LPNs stating that they were responsible for large numbers of residents, making it difficult to complete basic care tasks such as showers, turning and positioning, and timely medication administration. Staff reported having to rush care and being unable to provide the level of attention required by residents' care plans. Facility leadership, including the Director of Nursing and the Administrator, acknowledged awareness of the state minimum staffing requirements and admitted that the facility was not meeting these standards. The Director of Human Resources/Scheduler confirmed the minimum staffing numbers for each shift, but also noted challenges with call-ins and maintaining adequate coverage. The deficiency was substantiated by both documentation and direct testimony from residents and staff, demonstrating a consistent pattern of insufficient staffing that impacted resident care.