State Findings:
Based on observation, interview, review of the facility’s staffing, and review of the facility’s staffing policy, it was determined the facility failed to provide sufficient staff to provide care for residents. Interviews with residents and staff revealed there was not enough staff to give showers; therefore, residents were often given bed baths instead of showers. Interviews with residents and staff revealed ice water was not passed to residents routinely unless residents asked for it, due to being short-staffed. Further, residents who had physician orders [REDACTED]. Refer to F558 and F692.
Interview with State Registered Nurse Aide (SRNA) #8 on 01/16/2020 at 2:09 PM revealed Resident #2 went to the nurses’ station on 01/15/2020 and stated he/she had rung the call light for an hour because he/she required assistance being transferred from his/her wheelchair to the commode. She stated she apologized to the resident and got another SRNA to assist her with Resident #4. SRNA #8 stated the facility was short-staffed and had been for a while. She stated ice water is not always passed twice during her shift and residents that were hard to transfer received bed baths on the days that the facility was short-staffed instead of showers.
Interview with the Administrator on 01/16/2020 at 8:08 PM revealed he was aware the facility was short-staffed and he was attempting to fill vacant positions.
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