Failure to Maintain Adequate Nursing Staff Levels
Penalty
Summary
The facility failed to provide sufficient nursing staff to consistently meet the needs of all residents, as evidenced by a review of staffing schedules and interviews with staff and residents. The facility's own Facility Assessment established required staffing levels for Certified Nurse Aides (CNAs) and Licensed Practical Nurses (LPNs) for each shift, but actual staffing frequently fell below these levels across multiple days and shifts. For example, on several occasions, the number of CNAs and LPNs scheduled was less than what was determined necessary by the facility's assessment, particularly on evening and night shifts. Staff interviews confirmed ongoing staffing shortages. CNAs reported that staffing was inadequate, making it difficult to complete necessary care tasks such as showers and timely response to resident needs. They described working short-staffed, lacking help, and being unable to provide good care due to the high number of residents assigned to them. A resident reported waiting up to 2.5 hours for call bell responses and stated that delays in care depended on which staff were working. The resident also described being told by administration that there were many other residents to care for, indicating that staff were overwhelmed by their assignments. Administrative staff, including the Staffing Coordinator, DON, and Administrator, acknowledged the staffing issues. The Staffing Coordinator stated that staffing often fell below the minimum required, especially on weekends, and that incentives such as gift cards and bonuses were not always effective in attracting staff. The DON was aware of the inadequate staffing but was unable to specify the required staffing numbers for all units. The Administrator noted that the facility was in a staffing crisis, that the Facility Assessment did not reflect weekend or low census needs, and that efforts to address staffing shortages had not been successful. The deficiency was cited under 10NYCRR 415.13(a)(1)(i-iii).