Insufficient CNA Staffing on Unit During Weekend Shifts
Penalty
Summary
The facility failed to provide sufficient nursing staff on one of its units during a specific weekend, as evidenced by staffing records and staff interviews. Payroll Based Journal (PBJ) data and as-worked schedules showed that only two certified nursing assistants (CNAs) were scheduled for a unit with a census of 59 residents during the day shift on both Saturday and Sunday. Staff interviews confirmed that the standard staffing expectation was four to five CNAs per shift, and both the DON and CNAs acknowledged that the unit was understaffed on those days. The CNAs reported that, due to the low staffing, they had to prioritize essential care tasks, resulting in showers not being completed, though hygiene and feeding needs were met with assistance from other nursing staff. The deficiency was further supported by statements from the administrator and unit manager, who confirmed that staffing levels did not always meet the facility's assessment, especially on weekends due to turnover and call-outs. Despite the low staffing, there were no documented incidents, grievances, or resident council concerns related to unmet needs or accidents during the period in question. Resident interviews did not reveal significant concerns, except for one resident who requested a change in shower scheduling, which was subsequently addressed. The facility's own assessment indicated that four to five CNAs per shift were needed based on census and acuity, but this standard was not met on the dates reviewed.