Nurse staffing posting missing resident census. The nurse staff posting observed by the DON office listed nursing hours by shift and discipline, but the census section was blank. The DON confirmed the census should have been included, and facility policy required the resident census at the beginning of the shift to be posted with the staffing information.
The facility failed to ensure daily nursing staffing postings were accurately completed and posted. Review of staffing sheets showed multiple blank shifts across several months and several dates with no RN identified, including shifts worked by agency nurses. The DON stated charge nurses were responsible for completing the form each shift, but she did not monitor the process, and staff interviews showed inconsistent understanding of who completed the posting.
Outdated Nurse Staffing Post: The facility failed to keep the nurse staffing post updated each shift, and surveyors repeatedly found staffing information posted with prior dates. Front desk staff, the staffing coordinator, and the DON gave differing descriptions of who was responsible for updates, while the facility policy required the number of RN, LPN/LVN, and CNA staff to be posted at the beginning of each shift in a prominent, accessible, and readable location.
A facility failed to ensure daily nurse staffing data was posted over the weekend. During observation, the staffing sheet in the main entrance was still dated Friday, and later that day it was replaced with a Sunday sheet. The administrator stated staffing sheets should be posted each morning and confirmed Saturday and Sunday sheets had not been posted as expected.
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.
Nurse staffing posting was not updated daily and was found posted with outdated dates on multiple observations. NA-A confirmed the posting was outdated, SC-B stated she changed staffing hours for the coming week but did not update the posted sheets until later, and the DON verified the posting should be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 Staffing Posting: The facility failed to ensure the daily staffing posting included all required information. The posting showed the date and the total number of licensed staff with their designation, but it did not include the facility name, a clearly identified census, or the total actual hours worked by licensed staff. The senior manager of scheduling operations, RN-A, the DON, and the administrator gave differing accounts of who was responsible for updating weekend changes and acknowledged uncertainty about the exact posting requirements.
Daily staffing postings on all three units showed staff names and disciplines, but the hours scheduled and current census were not visible. The DON confirmed the census was not included, and the administrator verified that the hours on the back of the posting reflected the prior day's schedule because the new posting had been placed on top of it.
Surveyors found that required daily nurse staffing information was not posted anywhere in the building, including the administrator’s office door, primary areas, hallways, or entrance. The administrator acknowledged responsibility for posting the information and admitted it was not printed or posted. Facility policy required that nurse staffing information be posted daily, seven days a week, in a readable format and be readily available to residents and visitors, but this was not done, potentially affecting all 33 residents and visitors seeking this information.
Incomplete Daily Nurse Staffing Posting: The facility failed to post required nurse staffing information daily and the posting did not include the daily census or the total number of licensed nursing staff working each shift. The DON stated she usually completed the posting at the end of the week because of call-ins and was not aware census and total licensed staff had to be included. The facility policy required the information to be posted at the beginning of each shift.
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