Failure to Maintain Adequate Nursing and CNA Staffing Levels
Penalty
Summary
The facility failed to provide sufficient nursing staff to meet residents' needs in accordance with its own staffing policy on multiple sampled days. Review of the facility’s Direct Care Services Hours Per Patient Day (DHPPD) records showed that on seven of ten sampled days, total nursing and CNA hours fell below the facility’s stated minimums of 3.5 total nursing DHPPD and 2.4 CNA DHPPD, absent any waiver. On one morning shift, the DON confirmed there were only five CNAs assigned to care for 79 residents on the skilled unit. The DON acknowledged the facility was experiencing staffing shortages and that adequate staffing is needed to ensure staff can provide care and services to residents. A resident admitted with hemiplegia and hemiparesis affecting the right dominant side, epilepsy, and muscle weakness, and assessed as cognitively intact and requiring moderate to extensive assistance with ADLs, reported that when he requested showers on his scheduled shower days, staff told him his shower would be delayed until the afternoon because the facility did not have enough staff. A CNA interviewed on the same day stated she was unable to provide this resident’s shower due to short staffing. The CNA also reported that when residents have private caregivers, the facility allows those caregivers to perform CNA responsibilities such as feeding, repositioning, changing, and cleaning residents to ease staff workload.
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