Health inspection·October 7, 2022

§483.35(g) Nurse Staffing Information. §483.35(g)(1) Data requirements. The facility must post the following information on a daily basis: (i) Facility name. (ii) The current date. (iii) The total number and the actual hours worked by the following categories of licensed and unlicensed nursing staff directly responsible for resident care per shift: (A) Registered nurses. (B) Licensed practical nurses or licensed vocational nurses (as defined under State law). (C) Certified nurse aides. (iv) Resident census. §483.35(g)(2) Posting requirements. (i) The facility must post the nurse staffing data specified in paragraph (g)(1) of this section on a daily basis at the beginning of each shift. (ii) Data must be posted as follows: (A) Clear and readable format. (B) In a prominent place readily accessible to residents and visitors. §483.35(g)(3) Public access to posted nurse staffing data. The facility must, upon oral or written request, make nurse staffing data available to the public for review at a cost not to exceed the community standard. §483.35(g)(4) Facility data retention requirements. The facility must maintain the posted daily nurse staffing data for a minimum of 18 months, or as required by State law, whichever is greater. 22 CCR §72523. Patient Care Policies and Procedures. (a) Written patient care policies and procedures shall be established and implemented to ensure that patient related goals and facility objectives are achieved. The facility failed to post in Station 1 and Station 2 on a daily basis the actual hours worked by licensed and unlicensed nursing staff directly responsible for resident care per shift. As a result, the actual staffing information on 8/27/2022 to 8/29/2022 were not readily accessible and available to residents and visitors. During an observation on 8/29/2022 at 3:02 p.m., the Direct Care Service Hours Per Patient Day (DHPPD - refers to the actual hours of work performed per patient day by a direct caregiver), dated 8/26/2022, was posted at Station 1. On 8/29/2022 at 3:09 p.m., during an observation, the DHPPD, dated 8/26/2022, was posted at Station 2. During a concurrent interview, Charge Nurse 1 (CN 1) stated the DHPPD for Station 2 was not updated. CN 1 stated it should be posted daily at the station visible to everyone and the information on the DHPPD were for the CNAs, nurses, residents, and visitors. On 8/29/2022 at 4:19 p.m., during an interview, the Director of Staff Development (DSD) stated he was responsible for ensuring the staff posting was updated daily. The DSD stated staff posting should be updated daily so that staff, residents, and the residents' families are aware of the facility census and the staff hours of service per resident. On 8/30/2022 at 9:37 a.m., during an interview, the Administrator (ADM) stated the DHPPD should be posted where it was visibly seen for family, visitors, and residents to inform them the allotted staff hours based on census. A review of the facility's policy and procedure titled, "Posting Direct Care Daily Staffing Numbers," dated 7/2016, indicated it is the policy of the facility to post, on a daily basis for each shift, the number of nursing personnel responsible for providing direct care to residents. The policy stated that the number of licensed nurses and unlicensed nursing personnel directly responsible for resident care will be posted in a prominent location, accessible to residents and visitors, within 2 hours of the beginning of each shift. The shift supervisor shall date the form, record the census, and post the staffing information in the location designated by the administrator. The posting will include the name of the facility, the date for which the information is posted, resident census at the beginning of the shift, twenty-four-hour shift schedule, type and category of nursing staff working, actual time worked for each category and type of nursing staff, and total number of licensed and non-licensed nursing staff working for the posted shift. The facility failed to post in Station 1 and Station 2 on a daily basis the actual hours worked by licensed and unlicensed nursing staff directly responsible for resident care per shift. As a result, the actual staffing information on 8/27/2022 to 8/29/2022 were not readily accessible and available to residents and visitors. The above violation had direct or immediate relationship to the health, safety, or security of all residents.