Health inspection·August 18, 2022

F 0732 Post nurse staffing information every day. Level of Harm - Minimal harm or potential for actual harm Based on observations, record reviews, and interviews, the facility failed to accurately post the required daily staffing information. Residents Affected - Few Findings included: On 08/15/2022 at 9:02 a.m., upon entry into the facility, an observation of the bulletin board located on the 1st floor next to the Nurse's station, revealed there was no current Daily Staffing Sheet, a document that provided information of the number of residents and the total hours of nursing staff working all on three shifts for that day. On 08/15/2022 at 3:13 p.m., an observation revealed no Daily Staffing Sheet posted for the current day. On 08/16/2022 at 7:35 a.m., while touring the 1st floor nursing unit, an observation revealed no Daily Staffing Sheet posted for the day. On 08/16/2022 at 10:15 a.m., during an interview with the Director of Nursing (DON), the Daily Staffing Sheets for the current week to include Sunday 08/14/2022 through Thursday 08/18/2022 was requested. On 08/16/2022 at 12:20 p.m., the DON delivered copies of the requested information regarding the Daily Staffing Sheets On 08/16/2022 at 3:05 p.m., an observation was made of the Daily Staffing Sheet posted for the day with the following information: Census:45, Certified Nursing Assistants (CNA): 120.25 hours, Licensed Practical Nurses (LPN): 48.0 hours, Registered Nurses (RN): 12.0 hours, RN/DON: 8.0 hours, RN with administrative duties: 10.0 hours On 08/17/2022 at 12:35 p.m., an observation revealed the Daily Staffing Sheet was dated 08/16/2022. On 08/17/2022 at 3:05 p.m., an observation revealed the posted Daily Staffing Sheet was still showing information from 08/16/2022. On 08/18/2022 at 8:38 a.m., an observation revealed the Daily Staffing Sheet was still showing Page 1 of 2 105732 105732 08/18/2022 The Cedar at Mease Life 910 New York Ave Dunedin, FL 34698

F 0732 information from 08/16/2022. Level of Harm - Minimal harm or potential for actual harm On 08/18/2022 at 8:42 a.m., an interview was conducted with the Staffing Coordinator. She stated the census was: 52 for Sunday 08/14/2022, 52 for Monday 08/15/2022, 51 for Tuesday 08/16/2022, and 52 for Wednesday 08/17/2022. She said she received the census numbers from the admissions office and did the calculations. The information was then given to the DON for her to post. Residents Affected - Few On 08/18/2022 at 9:46 a.m., during an interview with the DON, she stated she was responsible for posting the Daily Staffing Sheet. She showed a current copy of the Daily Staffing Sheet for Thursday 08/18/2022 and said she was in the process of posting it. She also stated she forgot to post the Daily Staffing Sheet on Wednesday 08/17/2022. On 08/18/2022 at 10:26 a.m., an interview was conducted with the Nursing Home Administrator (NHA). She explained in their morning meeting, the census was discussed as of midnight the previous day. Changes were made if a resident was sent out and a discussion was conducted related to any potential new admits. The staffing numbers were then created or adjusted by the DON and the hours were calculated by the Staffing Coordinator. She said the DON completed the staffing sheet and would post it on the bulletin board, which is located next to the first unit Nurse's Station. The NHA was shown the Daily Staffing Sheets which were received from the DON on Tuesday 08/16/2022. The first was dated for Sunday 08/14/2022, the second was for Monday 08/15/2022, and the third was for Tuesday 08/16/2022. All three sheets showed a total census of 45. The NHA was made aware that during an interview with the Staffing Coordinator, she stated the census for Sunday was 52, Monday was 52 and Tuesday was 51. The NHA stated, I honestly cannot give a good reason why the numbers are different, we screwed up and no one caught it or corrected it. I will investigate it and see what happened. A review of the policy titled, Posting Direct Care Staffing Numbers, revised July 2016 revealed: Policy Statement Our facility will post on a daily basis for each shift the number of nursing personnel responsible for providing direct care to residents. Policy Interpretation and Implementation: 1. Within two (2) hours of the beginning of each shift, the number of Licensed Nurses (RNs, LPNs, and LVNs) and the number of unlicensed nursing personnel (CNAs) directly responsible for resident care will be posted in a prominent location (accessible to resident and visitors) in a clear and readable format. 105732 Page 2 of 2