| 87 |
RIO RANCHO CENTER |
325033 |
4210 SABANA GRANDE SE |
RIO RANCHO |
NM |
87124 |
2018-02-12 |
725 |
F |
0 |
1 |
M2BO11 |
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and interview the facility failed to ensure sufficient nursing staff numbers to answer call lights in a timely manner, ensure all residents received restorative therapy as ordered and attend to residents' needs for all 113 residents identified on the alphabetical resident census provided by the Administrator on 02/05/18. This deficient practice has the potential to negatively impact resident safety and comfort, and to impede processes such as restorative therapy, timely incontinence care, regular turning schedules, timely showers and appropriate assistance with meals. The findings are: [NAME] On 02/05/18 at 2:38 pm, during an interview with R #26, he stated the staff is always complaining among themselves that they are short staffed. He stated that during the week it takes 20 minutes for them to answer his call light and about 30 minutes on the weekends. B. On 02/05/18 at 2:44 pm, during an interview with R #8, she stated that she needs help to transfer herself from her wheelchair to the toilet. She stated that on three separate occasions, she soiled her brief because staff did not answer call light in time. She stated that after she soiled herself she could not find any staff in her hallway so she had to propel herself to the nurse's station and asked someone to help her. R #8 stated this was very embarrassing and that even after she requested help, she had to wait another 30 minutes before she received help changing her brief. C. On 02/06/18 at 8:42 am, during an interview with R #15, she stated there is not enough staff. She stated that at night she will push her call light and no one will come. She stated that she has soiled her brief because the staff take too long to respond to her call light. D. On 02/06/18 at 8:35 am, during an interview with R #14, she stated the night shift will take a long time to answer her call light. She stated she waited for almost two hours for pain medications. E. On 02/06/18 at 9:59 am, during an interview with R #61, she stated they could use more staff since she has to wait over an hour and a half during meal times for staff to answer her call light. She stated that after 10:00 pm she sometimes has to wait up to 2 hours for pain medication. F. On 02/06/18 at 10:19 am, during an interview with R #2, she stated the staff takes a while to assist her to the bathroom. She stated that she does not want to go to the bathroom in her pants so she will hold it and becomes very constipated. [NAME] On 02/06/18 at 10:39 am, during an interview with #55, he stated there are less staff on the weekend and he has to wait up to an hour for assistance. H. On 02/06/18 at 2:41 pm, during an interview R #5, stated that showers are too short due to staff shortage. She also stated that she has occasional diarrhea and sometimes waits for an hour to get cleaned up. She stated that it feels like acid is on her. I. On 02/07/18 at 9:39 am, during an interview with R #47, he stated he has to wait over 30 minutes for staff to respond to his call light to help him change or with transfers. He stated that the staff sometimes tie the call light so it is out of his reach and then he has the yell to get the staff's attention. [NAME] On 02/09/18 at 1:46 pm, during an interview with Restorative Aide (RA) #1, she stated there are 2 restorative aides, herself and RA #2. She stated that they alternate their work schedule so that one of them is working each day of the week. RA #1 stated that sometimes her workload gets to be too much for her. She stated that sometimes they have up to 23 residents on the restorative program that she works with in addition to the assistance she provides during meals as well as weighing residents. She stated when they have around 22 or 23 residents on the restorative program, she sometimes does not have enough time to get to all of them and some residents miss their restorative therapy. RA #1 stated that she has worked at the facility for a long time and remembers when they used to have 7 restorative aides and that it slowly dwindled down to 1 restorative aide. She stated that she is glad there are currently 2 restorative aides but that when the number of residents needing restorative therapy goes up there is not always enough time to get to everyone. RA #1 also stated that she is told to work the floor as a CNA about 2 times a week which also takes time away from the restorative therapy program. She stated that she does get complaints from residents about having to wait a long time for their call light to be answered. K. On 02/09/18 at 2:57 pm, during an interview with RA #2, she verified that when the number of residents on the restorative program gets to be around 22 or 23 residents they do not always get everyone's therapy completed as ordered. L. On 02/09/18 at 2:17 pm, during an interview with the Staffing Coordinator, she stated that the number of staff they have depends on the resident census and the acuity of the residents. She stated that she considers fully staffed to be a PPD (Per Patient Day - a calculation used to determine how many direct care staff hours, on average, are devoted to a single resident each day) between 3.0 and 3.17 hours. She stated they have met those numbers for the most part. She stated the only time they had problems with staffing on the weekend was back in (MONTH) (YEAR) during the balloon fiesta when a lot of people called in. M. Record review of the facility staffing calculation worksheet for PPD hours from 11/01/17 to 01/31/18 revealed a range of 2.66 to 3.79 with many of the lower numbers occurring on the weekends: 1. On 11/11/17 (a Saturday) the PPD was 2.94. 2. On 12/02/17 (a Saturday) the PPD was 2.91. 3. On 12/09/17 (a Saturday) the PPD was 2.90. 4. On 12/10/17 (a Sunday) the PPD was 2.94. 6. On 01/06/18 (a Saturday) the PPD was 2.78. 7. On 01/13/18 (a Saturday) the PPD was 2.88. 8. On 01/20/18 (a Saturday) the PPD was 2.66. 9. On 01/27/18 (a Saturday) the PPD was 2.86. 10. On 01/28/18 (a Sunday) the PPD was 2.86. N. On 02/12/18 at 10:15 am, during an interview with Licensed Practical Nurse (LPN) #3, she stated that she usually has anywhere from 27 to 30 residents to care for on her shift. When asked whether they have enough staff to meet the needs of all the residents, she responded sometimes. She stated that she usually works on the hall that has residents that are high acuity. She stated that at one point she had 5 residents on IV (intravenous) therapy, 8 residents that needed CBG (capillary blood glucose) checks and 3 residents that had [DEVICE]s (tube inserted through the abdomen that delivers nutrition directly to the stomach). She stated that when she has such high acuity residents it takes her longer to care for their needs and sometimes has to work overtime. LPN #3 stated that they frequently have new admitted residents on her hall which require a lot of paperwork and assessments to be completed which takes time away from other residents. She stated that she thinks they need at least 5 CNAs (Certified Nursing Aides) for the north side of building however they usually only get 4 CNAs. O. Record review of a grievance dated 10/11/17 submitted by the resident council stated. Resident Council reported that call lights are taking a long time to answer up to 30-45 minutes. It is generally happening on evening and night shift and facility wide. P. On 02/12/18 at 10:57 am, during an interview with the Administrator, he stated that when they have complaints about long call light response time, they do a call light audit which involves measuring how long staff take to answer call lights. He stated that in response to the resident council grievance in (MONTH) (YEAR) they educated CNAs to respond to call lights in a timely manner. He stated they did not do a call light audit because the problem was not widespread. He stated that the north side of the building is staffed with 2 nurses who split the residents based on hallway and whether the room number is odd or even. He stated they do not split the workload based on the acuity of the residents. |
2020-09-01 |