Failure to Accurately Post Daily Nurse Staffing and Resident Census Information
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.
Penalty
Resources
Below are regulatory guidelines relevant to this citation:
Incomplete Daily Nurse Staffing Postings: The facility failed to ensure daily staffing sheets were accurate and posted for each shift. Survey review found missing nurse data, CNA data, and resident census information on multiple dates, and the sheets did not document the actual hours worked by nursing staff. The DON stated the staffing sheets should have been completed correctly but were not.
Inaccurate daily nurse staffing postings were identified when the facility’s daily postings did not match the actual staffing levels shown on the schedules. The DON and administrator stated the postings were completed by the receptionist and were not updated for call-ins, no-shows, or staff picking up shifts. The receptionist and staffing coordinator confirmed the postings were not being adjusted to reflect changes, and review of the schedules and postings showed they did not match.
The facility failed to post accurate nurse staffing information on a daily basis. Surveyors observed staffing sheets posted with future dates, including postings at the main entrance and nursing station, and one posting showed a census that did not match the Resident Listing Report. The DON, Administration, and Staffing Coordinator acknowledged the staffing information was being prepared and posted ahead of time, and the census on the sheet was incorrect.
Failure to post and retain daily nurse staffing information. Observation showed no staffing sheet posted, and an AN stated the staffing information should be easily viewed. The facility also did not keep records of all daily nurse staffing postings for the required 18 months, despite policy stating the information must be readily available to residents, staff, and visitors.
A facility failed to post current and accurate nurse staffing information at the beginning of the shift. The staffing sheet in the lobby showed an outdated date, and the resident census and staffing hours did not accurately reflect the current total hours worked by licensed and unlicensed nursing staff directly responsible for resident care. The NHA confirmed the required staffing and census information was not posted correctly.
Nurse staffing posting was not updated daily and was found posted with outdated dates on multiple observations. NA-A confirmed the posting was outdated, SC-B stated she changed staffing hours for the coming week but did not update the posted sheets until later, and the DON verified the posting should be current so families and visitors could see how many residents were in the facility and how many staff were working.
Incomplete Daily Nurse Staffing Postings
Penalty
Summary
The facility failed to ensure nurse staffing information was accurate and posted daily for each shift. During review of the facility daily staffing sheets, the surveyor found missing nurse staffing data and census data on multiple dates, including missing resident census entries and missing nurse and CNA data for specific shifts. The daily staffing sheets also had not documented the actual hours worked by nursing staff. On 6/8/26 at 1:30 PM, the DON stated the daily staffing sheets should have been completed correctly and had not been.
Inaccurate Daily Nurse Staffing Postings
Penalty
Summary
The facility failed to ensure that required nurse staffing information was posted each day with an accurate total number and actual hours worked per shift for licensed and registered staff on each shift. Review of the daily staff postings and staff schedules for the past month showed the postings did not accurately reflect actual staffing levels during each day. The DON and administrator stated the postings were completed by the receptionist and did not reflect changes such as call-ins, no-shows, or staff picking up shifts. The receptionist stated she filled out the posting form from the schedule sent by the staffing coordinator and that no one updated the posting for staffing changes. The staffing coordinator stated she was responsible for the schedule and forwarding daily information to the receptionist and DON, but not the staff posting, and she was not aware of anyone updating the postings to reflect call-ins, no-shows, or picked up shifts. Review of May and June 2026 schedules and postings confirmed they did not match, and the facility policy on daily staff postings was not provided.
Inaccurate Daily Nurse Staffing Posting
Penalty
Summary
The facility failed to ensure accurate nurse staffing information was posted on a daily basis. During observations on 6/1/2026, staffing information dated 6/1/2026 was posted at the main entrance, but the census listed as 103 did not match the Resident Listing Report census of 102. Later that same day, staffing information dated 6/2/2026 was observed posted, and on 6/2/2026 staffing information dated 6/3/2026 was posted at the main entrance. On 6/3/2026, staffing information dated 6/4/2026 was posted at the 100 Hall nursing station near the off-hours facility entrance. During interview, the DON confirmed the staffing information posted was dated 6/4/2026 and stated the scheduler would prepare the staffing information sheet before leaving and corrections would be made the next day. The DON also stated the staffing sheet should not be posted in the front and should be placed behind the current day until the new shift starts. Administration stated the staff coordinator should not post the staffing information the day before and should post the current staffing information for the day. The Staffing Coordinator stated she had been putting the staffing information out before leaving at the end of the day for the following day and did not notice the census was incorrect.
Failure to Post and Retain Daily Nurse Staffing Information
Penalty
Summary
The facility failed to ensure that the daily nurse staffing sheet was posted and failed to retain the required 18 months of daily nurse staffing postings. On 06/01/2026 at 07:37 AM, observation showed that no nurse staffing sheet was posted. During an interview on 06/03/2026 at 01:40 PM, Administrative Nurse D stated that staffing should be posted where it could easily be viewed and that the facility did not keep documents of all daily posted nurse staffing from the last 18 months due to high turnover. The facility policy, Nurse Staffing Posted Information dated 02/01/2026, stated that nurse staffing information was to be made readily available in a readable format to residents, staff, and visitors at any given time.
Failure to Post Current Nurse Staffing Information
Penalty
Summary
The facility failed to ensure that current and accurate nurse staffing information was posted at the beginning of the shift. On observation in the main lobby at the reception desk, the posted nurse staffing information showed an outdated date of 4/3/26, and the resident census and staffing hours did not accurately reflect the current total number of hours worked for licensed and unlicensed nursing staff directly responsible for resident care for the current date. During an interview, the Nursing Home Administrator confirmed that the facility failed to post the required current facility information for staffing hours and the facility census.
Nurse Staffing Posting Not Updated Daily
Penalty
Summary
The facility failed to ensure the nurse staff posting was posted daily and updated to reflect current staffing. Surveyors observed the posting on multiple occasions and found it dated 5/26/26 on 5/27/26 at 2:15 p.m. and again on 5/28/26 at 6:58 a.m., dated 5/26/25 on 5/27/26 at 4:10 p.m., and dated 5/28/26 on 5/29/2026 at 8:13 a.m. The deficiency affected all 24 residents residing in the facility. During interview, NA-A verified the posting was dated 5/26/26 and stated it was important for families and visitors to see how many staff were working. SC-B stated she changed the nurse staffing hours on Thursdays for the coming week but did not update the posted sheets, and instead made the changes in the computer after they occurred when she returned on Mondays. A review of the next week's schedules showed the census as 24, and one schedule dated 5/30/26 had zeros for all staff listed with a census of 24. The DON verified the nurse staff posting should be posted daily so anyone could see how many residents were in the facility and how many staff were working, and stated it was important so families could have confidence there was enough staff to take care of their family members.
Trusted data from CMS and state health departments
Every citation, penalty and Plan of Correction is sourced from public CMS records (latest release July 29, 2026) and official state health department websites — never guesswork.
In your survey window? See what surveyors are citing.
The Survey-Prep Report maps your facility's risk from 12 months of CMS and state citation data — what's being cited around you and what to check first. $129 one-time.