| 85 |
ORONO COMMONS |
205031 |
117 BENNOCH RD |
ORONO |
ME |
4473 |
2018-04-05 |
725 |
E |
1 |
0 |
G71711 |
> Based on observations, interviews and record reviews the facility failed to ensure sufficient staff was scheduled and on duty to meet the needs of residents that reside on 2 of 2 units (Riverview unit and Homestead unit) Findings: On 3/26/18 at 12:50 p.m., during a resident interview with a surveyor, Resident #2 stated that sometimes there are only 2 certified nurse assistants (CNA's) in the evenings, resulting in the resident having to wait, what seems forever, for help to go to the bathroom. Resident #2 stated that they rang their bell one evening to go to the bathroom and nobody answered it for half an hour so the resident attempted to take themselves to the bathroom and landed on the floor (denied any injuries) and hit their head. Resident #2 stated he/she called out, and when staff finally came in the room, staff stated that they had heard someone calling but didn't know where it was coming from. In addition, the resident stated that getting showers is a problem as well. Resident #2 is supposed to get a shower once a week in the evenings and at one time they went without a shower for about 5 weeks. Resident #2 stated they did refuse a few showers because by the time the staff could get them in the shower it was 10 o'clock at night and that was too late to take a shower. Resident stated that he/she has Depression and when staff don't have time to pay attention to their needs it upsets him/her. Resident stated that approximately 1 week ago he/she was put on the commode and was left there for 45 minutes before staff came back to assist them. Resident stated if they had enough staff they would not have to wait to get help. Record review indicates that no refusals for showers are documented. For the month of (MONTH) up to the 27th, resident has received 2 showers. Incident/Accident reports reviewed, resident did have a fall on 3/23/18, call bell log indicates call bell rang for 10 minutes. On 3/26/18 at 5:00 p.m. during an interview with a surveyor, Resident #3 stated the residents can see when they are short staffed, the CNA's don't have time to spend the usual amount of time with you, like when they give you a bath they do the best they can in a short amount of time because they have so many others to take care of. A lot of the time at night they are only 2 girls on the floor. Tonight, there are only 2 girls to help us and you end up waiting for help. The girls are doing the best they can, they need more help so they can help us like we need to be helped and not have to wait so long. On 3/26/18 between the hours of 12:20 p.m. to 5:10 p.m., observations were made of the Riverview unit and the Homestead unit; surveyor observed staff on the floor for day shift. Staffing sheets indicated the medical records person was assigned to work the Riverview unit; during the surveyors' observations this staff was observed 1 time on the unit and was not seen again during course of this investigation. The medical records office is located on the bottom level of the facility. On 3/27/18 at 8:45 a.m., during an interview with a surveyor, a family member stated that how and when the resident gets help all depends on how many staff are working. When there are enough staff and I ring the bell for staff to come assist resident with toileting needs they come right away, but when they don't have the staff, and it's more often they don't have enough staff, we have to wait a while. They take good care of residents but they need more staff to help everyone the way they want to be helped in a timely manner. On 3/27/18 at 8:55 a.m., during an interview with a surveyor, Resident #4 stated that there are not enough staff to help everyone in a timely manner. He/she stated they do not wait for staffs help because if they did they would end up being incontinent in their clothes. Resident #4 stated that they are told to wait for staffs help to prevent falls but waiting 20 minutes to go to the bathroom is too long and that they would end up making a mess in their pants and that is very upsetting to them. On 3/27/18 at 9:50 a.m., during an interview with a staff member they stated that a week or twi ago there was only 2 CNA's for the entire Homestead unit. Evening shift is the worst shift, most evenings they are not able to get all care done and what they can get done is not what the residents deserve. Most get put into pajamas and we have time to wash their bottoms and that's it, then we have to go to the next person while watching the wandering residents we need more eyes on this unit to watch and monitor all the residents we have a lot of wanderers that exit seek. On 3/27/18 during an interview with a surveyor, Resident #5 stated that he/she has been known to wait 1/2 hour to 1 hour for help. The staff say they are busy feeding people or they are busy helping someone else and this happens at least once or twice a week that they don't have enough people here. When they don't come in to help me I end up soiling my pants and that is very upsetting. I have to wear briefs and have a pad on my bed. The showers were not getting done but they are getting better about giving me one once a week. On 3/27/18 at 10:10 a.m., during an interview with a surveyor, Resident #6 stated that they don't have enough staff that going to the bathroom takes forever, sometimes there is only 1 girl for all of us people that is not enough staff. And what makes it worse is when I have to go to the bathroom I need help I can't do it myself and when I have to go I have to go. On 3/27/18 at 12:20 p.m., a surveyor observed a resident sitting in front of a bathroom door crying; the surveyor asked why he/she was crying and the resident stated that they have been waiting to go to the bathroom and they could not find the CNA to help them. Surveyor made the charge nurse aware. Surveyor asked if the resident was able to take themselves to the bathroom and the charge nurse stated I think they do, but went to get a CNA to assist the resident. On 3/27/18 at 1:10 p.m., during an interview with a surveyor a staff member stated, they call office people to come in to make the numbers (making state ratio) but they don't come out of their offices. The medical record person who was listed as working the floor yesterday did not provide any resident care. We are being pushed to provide the care but without staff we are back to not providing the showers. Some resident's teeth are not being brushed they don't have the basics offered because there are not enough staff on the floor. We try our best but we need help on the floor. The resident acuity isn't like it used to be. The residents need more and more help and they don't want to give us more help on the floor. On 3/27/18 at 2:00 p.m., during an interview with a surveyor, a staff member stated that We are losing so many staff members they are all tired of working shorthanded, we are even losing agency staff, they don't want to work here because of working so short all the time. Mouth care isn't getting done and it's not because the resident is refusing, it's because there are not enough of us to do all the care the residents need and deserve. On 3/27/18 at 2:20 p.m., during an interview with a surveyor, a family member stated the facility is short staffed they usually have 2 staff and sometimes 3 but that leaves residents waiting to use the bathroom and after supper everyone has to go at the same time but the bells will ring they go in and turn them off so it isn't registered on the log. Staff tell the residents they will be right back but don't come back. The staff are trying and they are good staff, they need help to do all they have to do, as simple as giving someone a meal tray and not having any silverware or not being able to position them properly because there is no one to help them. Some residents have talked to me about being put to bed late or I had one son tell me they had to got upset about their family member not receiving showers for 2 weeks. On 3/27/18 at 3:45 p.m., during an interview with a surveyor, Resident #3 who has a Brief Interview for Mental Status (BIMS) score of 15, stated that they do not refuse their restorative program, what happens is staff will get them up out of bed using the Hoyer lift and put them in their wheelchair and they just don't come back to do the restorative part of their care. Record review of Resident #3 restorative program indicates has 8 refusals documented, 3 days with no documentation and 3 days with activity did not occur for the month of (MONTH) up to the 27th. A surveyor confirmed these findings with the Director of Nursing on 3/26/18 at 4:50 p.m. and on 3/27/18 at 4:10 p.m. |
2020-09-01 |