Inaccurate Daily Nurse Staffing Sheet Posting: The facility failed to post accurate daily nurse staffing information, including the census. A staffing sheet posted behind the front desk listed a census of 71, while the census verified by Administrative Staff A was 67. The same outdated sheet remained posted the next day, and no current sheet was observed. Administrative Staff A stated the CSA updates the staffing sheets and that an incorrectly completed sheet would require education.
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.
Inaccurate daily nurse staffing information was posted near the admin offices, with a staffing sheet displayed under the wrong date before being updated later that morning. The ADON reported staffing oversight was split between two people, a charge nurse would post the sheet if a staffing coordinator was unavailable, and the sheet was expected to be updated daily. The facility also reported it did not have 18 months of staffing sheets and could only provide records from late December forward, despite policy requiring daily posting of direct care staffing data.
The facility failed to ensure daily nurse staffing data was posted and that the posted staffing sheets included required information. Review of the staffing postings showed an outdated date on the sheet and missing daily census information on multiple posted forms. An Administrative Nurse stated an Administrative Staff member was responsible for ensuring the sheets were posted, and that the receptionist posted them on weekends using the forms provided.
Incomplete Nurse Staffing Posting: The facility posted a daily nursing staffing sheet near the nursing station that listed employee numbers and hours but did not include the facility name or the daily nursing staff total hours. An Administrative Nurse stated he had not noticed the missing totals and was unaware the facility name had to be included on the daily staffing form.
Inaccurate posted nurse staffing information was observed near the nursing station. Review of staffing sheets showed missing scheduled hours on multiple sheets, and the resident census was absent on some sheets. An Administrative Nurse stated the unit floor nurse completed and posted the sheet before the next shift, and the facility policy required the DON or designee to ensure the daily RN, LPN, and CNA staffing schedule was posted at the entrance to each household.
The facility failed to ensure daily nurse staffing postings were accurate and complete. Surveyors observed multiple posted staffing sheets that did not include total hours worked and, at one point, did not list the facility name. Review of additional dates showed the same omission of total hours worked. An administrative nurse reported that a night-shift nurse completed and posted the next day’s staffing sheet and indicated that a column labeled "actual hours" was intended to represent total hours worked, despite the facility’s written policy requiring clear computation and recording of staffing levels and census information on the Daily Nurse Staffing form.
Failure to post nursing staff hours. Surveyors observed that the facility did not have posted census and direct care nursing staff hours accessible to residents and visitors. An Administrative Nurse stated the posting was usually done by the administrator and had not been posted because the administrator was absent, despite the facility policy requiring staffing information to be readily available in a readable format at all times.
Inaccurate daily nurse staffing posting. A charge nurse reported a census of 38 residents, but the daily staffing sheet listed 44 residents and did not include total scheduled hours for RN, LPN, and CNA staff. Review of prior staffing sheets showed the same census and continued missing scheduled-hour entries, and an admin staff member confirmed the omissions and stated the actual hours were only revised at the end of the day.
Surveyors found that daily nurse staffing information was not consistently posted or retained as required. Over an 18‑month review period, multiple days of staffing records were missing, and the sheet displayed during observation was not for the current date. Staff interviews showed that an administrative staff member was responsible for weekday postings and record retention, while charge nurses were expected to post and update prefilled sheets on weekends. A changeover in the personnel responsible for maintaining these records contributed to the inability to locate all required historical staffing sheets, despite a written policy requiring timely posting and 18‑month retention of nurse and CNA staffing data.
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