Insufficient Staffing Resulting in Delayed Resident Care
Penalty
Summary
The facility failed to provide sufficient nursing staff to meet the needs of all 48 residents, as evidenced by multiple sources including staff schedules, facility assessments, resident council meeting minutes, and interviews with residents and staff. The facility assessment indicated that staffing decisions should be informed by resident needs and contingency plans were in place for unplanned staffing shortages. However, review of staffing schedules revealed instances where only two or three CNAs were available for 48 residents during certain shifts, and staff interviews confirmed that call-offs were not always covered, leading to inadequate staffing levels, particularly on weekends and night shifts. Residents consistently reported long wait times for call light responses, sometimes up to 30-60 minutes, and difficulty receiving assistance with activities of daily living such as bathing, toileting, and scheduled showers. Several residents also noted that they were unable to participate in activities like smoking breaks due to lack of available staff. Resident council meeting minutes documented ongoing concerns about delayed care and insufficient help, especially for tasks requiring two staff members, such as using a mechanical lift. Staff interviews corroborated these concerns, with CNAs and LPNs stating that the workload was unmanageable with the current staffing levels, especially given the high number of residents requiring two-person assistance. Staff reported that routine care such as two-hour checks, showers, and restorative programs were not consistently completed. The staffing coordinator acknowledged the use of agency and temporary staff but confirmed that management did not always come in to cover shifts when call-offs occurred. The local Ombudsman was also aware of the ongoing staffing issues.