Complaint Investigation Report

Allegation: Staff is not able to meet resident's needs due to inadequate staffing. In regards to the allegation it is alleged that over the past 30 to 40 days there is not enough staffing at the facility to assist residents. Interview with the Executive Director revealed caregiver assistance is dependent on the level of care a resident may need or requires. Caregivers are provided assignment sheets with residents names to provide assistance to. Assistance with activities of daily living is dependent on what level of care the resident was assessed for. Caregivers are still required to respond to call button alerts from residents not on assignment sheet. Review of two (2) assignment sheets for the assisted living unit provided revealed 31-36 names with residents requiring varying degrees of assistance with toileting, transfer, bathing, dressing, grooming , escorting or status checks. For the assisted living unit there are three (3) shifts with three (3) to four (4) caregivers and one (1) to two (2) med-techs per shift with exception to the overnight shift. Interviews with staff and residents revealed on Wednesday, July 17, 2024 at 6 a.m. the Wellness Nurse at the time received a call from a med-tech informing her the only two (2) caregivers on site for the assisted living unit of the facility were threatening to walk out if they did not have a third caregiver on site. Both caregivers, Staff #1 (S1) and staff #2 (S2) confirmed in interviews they had been working with only two staff on most days for about two weeks and had gone from four caregivers to three caregivers prior to the two weeks. Interview with Health Services Director corroborates on the day at 6 a.m. staff threatened to walk out and were not performing their usual duties if a third caregiver did not arrive. Staff walked out at approximately 6:45 a.m. - 7 a.m. without having provided care to residents in the assisted living unit. Health Services Director, states the Wellness Nurse at the time called a caregiver from the Memory Care unit to cover until more staff arrived. LPA was able to confirm with memory care staff they received a call from the Wellness Director at 6:55 a.m. to assist. Three other staff arrived and were able to provide assistance to residents some time around 7:30 a.m. Interviews with five (5) out of the eight (8) residents interviewed revealed they have waited over 30 mins to receive assistance with four (4) of those residents citing the specific incident that occurred on Wednesday as one of the days they waited over 30 minutes. One (1) out of the eight (8) residents indicated that they have only heard from other residents concerns about response time. Seven (7) out of eight (8) residents interviewed are satisfied with the care being provided only citing the wait time to receive the assistance as a concern. Interviews indicate Wednesday was an Isolated incident, however, interviews indicate staffing has been a concern prior to the incident. Therefore the allegation is deemed Substantiated at this time.

Exit Interview conducted. Deficiencies cited (refer to LIC 9099-D). Appeal Rights explained and provided. Copy of report provided Executive Director via email.