F0732

C

Failure to Accurately Post Daily Nurse Staffing and Resident Census Information

Lexington, North Carolina Survey Completed on 01-07-2026

Penalty

No penalty information released

Summary

The deficiency involves the facility’s failure to post accurate daily nurse staffing information and to consistently include the resident census on the required daily staffing postings. Surveyors compared the facility’s daily posted nurse staffing sheets with the internal nursing schedules for a 30‑day period and found discrepancies on 28 of 30 days reviewed. On multiple dates, the number and type of staff (RNs, LPNs, NAs, and MAs) and the shifts worked, as shown on the public posting, did not match the actual staffing schedule. Examples included incorrect reporting of which shifts a medication aide worked, inaccurate counts of NAs on specific shifts, and misreporting of whether RNs or LPNs were present on evening and night shifts.

Specific dates showed substantial mismatches between the posted sheets and the internal schedules. On some days, the postings understated staff actually scheduled (for example, fewer LPNs or NAs listed than were scheduled), while on other days the postings overstated staffing (for example, listing RNs or MAs who were not scheduled to work those shifts). There were also instances where the posted sheets showed staff working certain shifts when the schedule showed no such staff, and vice versa. These discrepancies occurred across all three shifts and involved multiple staff categories, including RNs, LPNs, NAs, and MAs, over the period from early December through early January.

Surveyors also observed that the facility failed to include the resident census on the daily nurse staffing postings for certain days. During an observation in the lobby, the daily postings for two weekend dates lacked resident census numbers for all three shifts on one date and for the morning shift on the following date. Interviews with the weekend supervisor and the staff scheduler revealed that the scheduler, who did not work weekends, was responsible for all daily staffing sheets and had left the census information for those weekend days to be completed after returning to work. No staff member was assigned to complete or update the postings with the census on weekends, resulting in missing census information on the posted staffing sheets.

In interviews, the scheduling manager confirmed that the numbers on the daily postings did not match the actual staffing schedules for the reviewed dates. She explained that the facility had recently implemented a new payroll/scheduling system that generated the daily postings from a data report rather than from the actual working schedule, and she did not know how to edit the system to reflect the true number of staff who worked each day. The administrator also confirmed that the daily staff postings and the staffing schedules did not match and stated that the facility had recently begun using the new system and that the scheduler could not modify the postings to correct them. The administrator further stated that she expected the resident census to be present on the daily postings and was not aware that the weekend supervisor was not completing the census information on those days.