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.
Failure to Post Daily Nurse Staffing Hours: The facility did not consistently post the current daily nurse staffing list at the start of each shift. Surveyors observed that the prior day's staffing list remained posted instead of the current list, and the Administrator confirmed the staffing hours for the day were not posted. The facility also did not provide the requested policy on posted nursing hours.
The facility failed to keep the daily staffing posting current when staffing changed. The posting in the main entrance area was observed with an outdated date, and an LPN was seen replacing the page. Review of the staffing schedule showed extra NAs were added to help with missed baths, but the posting was not updated to reflect the added staff. The DON and administrator both confirmed the postings were not updated to match the actual staffing levels.
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Outdated Nurse Staffing Post: The facility failed to keep the nurse staffing post updated each shift, and surveyors repeatedly found staffing information posted with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.
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