Incomplete Nurse Staffing Posting and Missing Census/Hours: The facility failed to post required daily nurse staffing data in a clear, accessible format with the correct date, actual hours worked, and resident census. Surveyors found postings with missing actual hours, missing census, and at least one missing day, while the ADON stated postings were placed behind each other and no staff were assigned to verify the correct date. Record review also showed repeated missing actual hours and census across multiple months, and the ADM stated there was no policy for nurse staffing posting.
Nurse staffing disclosure was not updated with the correct date and remained posted with an older date near the nurse's station. The ADON stated the DON or ADON was responsible for replacing the staffing data in the morning, while the administrator stated the posting should be changed after midnight and before morning; the facility also stated it did not have a specific policy, only a mandatory postings document listing daily staffing by shift.
Nurse staffing information was not posted in a readily accessible location for residents and visitors. Surveyors found the daily staffing posting placed high on a wall behind a potted tree, making it difficult to read and not accessible to someone in a wheelchair. The ADM said there was no policy for the posting requirement, and the DON stated residents or visitors might have to ask someone if they could not read it.
Failure to post daily nurse staffing information in a prominent, accessible location. Surveyors observed the staffing sheet behind the nurses' station on multiple occasions, making it inaccessible to residents and visitors. The ADON said the sheet was updated each morning by her or the night nurse, and the DON and Administrator acknowledged the expectation that it be visible in the hallway for residents and visitors to see how many staff were available each shift.
Failure to Post Daily Nurse Staffing and Census Information: The facility did not post the required daily staffing and census document during facility tours, and the required RN, LPN/LVN, CNA, and census information was not posted at the beginning of each shift. The DON said the task had not been reassigned after the scheduler role changed, and the ADMIN said the posting duty had been missed for the prior two days despite the facility policy requiring the information to be posted within 2 hours of each shift start.
Failure to post daily nurse staffing information: The facility did not keep the staffing sheet updated and readily accessible in the lobby, and it was observed outdated before later being updated. RN C, ADON D, the DON, the Staffing Coordinator, and the ADM each described different expectations for who was responsible for posting the daily staffing sheet, and several stated they had not been instructed to update it or were off work when it was missed.
Daily Nursing Staffing Sign Not Updated: The facility failed to post current nurse staffing hours at the beginning of the shift, and the sign in front of the nurse's station displayed the prior day's staffing information instead of the current day's data. RN G stated she was responsible for ensuring the current hours were posted, and the DON stated the staffing hours were supposed to be updated daily so residents and family members could see how many nurses were working at any given time.
Failure to Post Daily Nurse Staffing Information: The facility did not post the daily nurse staffing information with the current date, resident census, and actual hours worked at the beginning of the shift. Surveyors observed no staffing posting at the front desk, and staff interviews showed uncertainty about who was responsible after the DON left. The staffing schedule and assignment sheet identified the nurses working, but the required information was not displayed for residents, visitors, and staff to see.
Failure to Post Daily Nurse Staffing Information: The facility failed to update the daily nurse staffing posting in a prominent location and the most current binder posting remained dated months earlier. The ADON said she could no longer pull the report from the computer system and was unsure whether anyone else was posting it, while the interim ADMN and DON stated the posting should be updated daily and include the census.
Failure to Post Daily Nurse Staffing Information: The facility did not post the required nurse staffing and census information with the current date and at the beginning of each shift. Surveyors observed a staffing report in the lobby that was dated incorrectly, and interviews with the DON, HR, and ADMIN showed the posting was normally handled by HR but was not completed as required. The facility policy required the staffing sheet to be posted daily with the current date and at the beginning of each shift.
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