Failure to Provide Sufficient Nursing Staff to Meet Resident Needs
Penalty
Summary
The facility failed to provide sufficient nursing staff to meet the needs of all residents, as evidenced by multiple reports from residents, family members, and staff. Several residents with significant medical conditions, including diabetes, COPD, hemiplegia, and chronic kidney disease, reported delays in response to call lights, infrequent showers, and unmet personal care needs. One resident stated it sometimes took staff 30 minutes or more to answer his call light and that he only received a shower once a week instead of the expected two times. Another resident reported waiting up to an hour for assistance and not consistently receiving scheduled showers. A family member also expressed concerns about a resident not receiving showers as required. Staff interviews corroborated these concerns, with several CNAs stating that the facility was often short-staffed, particularly on the day shift. Staff described difficulties in completing all required resident care, including showers and personal hygiene, due to insufficient staffing. Some staff reported having to cover multiple halls or pass on care tasks to the next shift, and noted that staffing levels had recently decreased from three to two staff members per hall. The Assistant Director of Nursing acknowledged that on certain days, the facility did not meet the calculated required nurse aide hours based on the facility assessment tool. Review of facility schedules and census reports confirmed that on several days, the number of CNAs scheduled was below the level needed to provide adequate care for the 63 residents. The Administrator confirmed that there was no facility policy on staffing, and the Assistant Director of Nursing stated that daily assignment sheets were not updated to reflect when staff left early or did not show up. These actions and inactions resulted in insufficient staffing to meet residents' needs for timely assistance and personal care.