cms_VT: 42
Data source: Big Local News · About: big-local-datasette
| rowid | facility_name | facility_id | address | city | state | zip | inspection_date | deficiency_tag | scope_severity | complaint | standard | eventid | inspection_text | filedate |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 42 | BURLINGTON HEALTH & REHAB | 475014 | 300 PEARL STREET | BURLINGTON | VT | 5401 | 2019-05-15 | 725 | F | 1 | 0 | YQQB11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** > Based on observations, resident, family and staff interviews, reviews of medical records and staffing patterns throughout the facility, and personnel record review, the facility failed to assure that sufficient staff is present on all units during all shifts to safely meet the acuity levels of the residents living in the facility. This is a repeat deficiency, having been cited during the last 3 recertification surveys on (MONTH) 26, (YEAR), (MONTH) 14, (YEAR) and (MONTH) 24, (YEAR), again during a follow-up survey on (MONTH) 4, (YEAR), and most recently cited during a complaint investigation completed (MONTH) 13, 2019. Specifics are detailed below: Per interviews with 2 family members, 3 residents, 13 line staff members and the complainants from 8 reports to the Department of Licensing (DLP), comments and concerns from them to 3 surveyors who conducted the investigations, indicate that the facility does not have enough staff to meet the needs of residents. In an interview with with a family member on the 2nd floor on 5/12/2019 as supper was finishing, s/he reports that there is not enough staff to provide the necessary care to residents on that unit at mealtimes and on the evening and night shifts. S/he further reports that food preparation at the steam table and delivery of meals to residents is not efficient, and often the food is cold when it is served. Two residents, seated nearby, nodded in agreement. Per observation on 5/12/2019 at 5:30 PM, seven residents are eating dinner in the dining room, 1 is being fed by staff when a resident seated at the same table, is trying to eat but his/her dish has fallen into his/her lap, resulting in attempts by the resident to scoop fallen food from the table into eating utensils. This is not observed by staff until the surveyor commented. This resident is hunched over in his/her wheelchair, with their head nearly on the table. The resident does not respond when asked if they are in need of help. In an interview on 5/12/2019 at 5:30 PM on the 4th floor, 2 residents who wish to remain anonymous stated that the facility has, and has had for quite a while, trouble keeping staff. The first resident states that you have to wait when you need something and it's worse at mealtime. The resident continues that it's never like this when you (surveyors) are not here (commenting on the number of staff in the dining area). Additionally, both residents commented on how difficult it is that so many staff are contracted (traveling) staff. They say that while they try hard, the [MEDICATION NAME] don't know them and that some don't have their hearts in it. They also say that the facility continues to lose regular staff. In an interview on the same unit at 7:30 PM a resident stated that recently, the call light was on for 25 minutes when s/he really needed to use the bathroom, I almost didn't make it. In an interview on the 3rd floor on 5/12/2019 at 4:45 PM a Licensed Nursing Assistant (LNA) stated that it is difficult when so many staff are [MEDICATION NAME] because they are too busy to really get to know the residents. The elderly residents need a routine and get stressed with so many different faces. In an interview on 5/12/2019 7:05 PM an LNA, who generally works on the 4th floor, stated that Things are the worst they've ever been and continued to state that management doesn't pay attention and things never get resolved. Staffing is awful. It's not consistent. [MEDICATION NAME] need more orientation. Residents aren't happy because they aren't getting what they need. They have long waits for care. In interview on 5/12/2019 at 8 PM, an LNA stated it's very stressful and we're very short staff. At one time there were 2 LNA's assigned to the 3rd floor and there were 3 residents who needed 1:1 staffing and 5 residents who were 2 assist with only 2 LNAs on the unit. When asked how the LNAs managed to do everything, the LNA stated we put the 1:1's in recliners at the nurses station. The LNA stated I've had nurses tell me to transfer a person who is a 2 assist, alone. We can't ask another floor because they're short staffed too. Housekeepers answer call lights. On 5/13/2019 at 9:50 AM an LNA stated I do mostly 12 hour shifts. I've worked in other places but this place is different than most I've seen. Last week I worked a 7 AM to 3 PM shift and then came back for a 7 PM to 7 AM shift. During the 4 hours I was gone the residents in one of the rooms I worked in (on 4th floor) hadn't been changed and one was wet and the other was wet and had a bowel movement (BM). Neither had been changed in the 4 hours I was gone. I have been told by another LNA just turn the call lights off and get back when you get to it because you get in trouble if the call lights stay on. During meals the food gets cold while 2 people help set the residents up and serve the trays. There are never as many people helping when you (surveyors) are not here. On 5/13/2019, in the afternoon, an LNA stated a few weeks ago we had 3 residents who needed 1:1 and there were only 2 LNAs. We took them out by the nurses stations in chairs so whoever was there could watch them. On Easter I was on the 4th floor and I was the only LNA on that unit because of call outs. The On-call person refused to come in to help. Sometimes residents don't get the right food or what they want because the [MEDICATION NAME] don't know them. Currently, the facility utilizes 27 [MEDICATION NAME] to staff the 4 units: 16 LNAs (Licensing Nursing Assistants) and 11 LPNs (Licensed Practical Nurses.) 17 of these were on duty, throughout the facility, on 5/12/2019, working 8, 12 or 16 hour shifts. Staff who were interviewed indicate that they often work 16 hour shifts. The Matrix used on 5th floor to determine resident needs indicates that 14 of 32 residents have dementia/ [MEDICAL CONDITION], 7 have experienced a fall, 5 are on Hospice, 5 have pressure ulcers and 28 receive either diuretics, anti anxiety medications, antipsychotics, hypnotics, antibiotics or a combination of several of these. This is provided by the charge nurse on that unit, who also confirms that usual staffing for evening hours on 5th floor is 2 nurses, one for each med cart and, 3 LNAs (but with split hours there are some evenings where only 2 LNAs are on duty after 9:15) The night staffing on 5th floor is 1 nurse and 2 LNAs. Per observation, the acuity log that the facility is using to determine staff needs does not include input from the LNAs and does not contain numbers to indicate how many residents are on a toileting program or those who are incontinent. Nor does it contain transfer needs, how much assistance is needed for ambulation or position changes while residents are in bed. This is confirmed by the assistant director of Nursing, during interview on 5/15/2019 in the late afternoon. S/he indicates that they are working on putting that aspect into place. The facility has a monitoring system housed on the 5th floor that is used to monitor entry into the building after hours. It does not have the capacity to monitor the driveway, beyond the mid point heading towards the road. Besides their regular duties of caring for residents, staff on the 5th floor are responsible to respond when the front doorbell rings. | 2020-09-01 |