Health inspection·April 7, 2022

F732 §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. On 2/28/2022, the California Department of Public Health (CDPH - or State Survey Agency [SSA]) made an unannounced visit to conduct the facility’s annual recertification survey. The facility failed to ensure staffing information was posted and updated daily, at the beginning of each shift, in a prominent place readily accessible to residents and visitors. As a result, residents and visitors were unaware of the total hours of nursing staff providing direct care to the residents per shift and if there was staff shortage. On 2/28/2022 at 7:35 a.m., during an observation of the lobby, the posted Direct Care Service Hours Per Patient Day (DHPPD - refers to the actual hours of work performed per patient day by a direct caregiver) was dated 2/25/2022 with a resident census of 118. On 3/2/2022 at 7:26 a.m., during an observation of the lobby, the posted DHPPD indicated a date of 2/28/2022. During an interview on 3/3/2022 at 1:58 p.m., the Director of Staff Development (DSD) stated the Staffer was responsible for posting the DHPPD in the lobby and at the Nurses' Station daily. During an interview on 3/3/2022 at 3:38 p.m., the Staffer stated she was responsible for posting the DHPPD during weekday both in the lobby and the Nurses' Station. The Staffer stated staffing information should have been posted timely. During an interview on 3/3/2022 at 3:59 p.m., Registered Nurse 2 (RN 2) staed she worked on 2/26/2022 and changed the staffing information posting at the Nurses' Station. RN 2 stated posting should have been changed in the lobby on 2/26/2022, 2/27/2022, and 3/1/2022 to ensure accurate staff posting. A review of the facility's undated policy and procedures titled, "Posting Direct Care Daily Staffing Numbers," indicated, number of nursing personnel responsible for providing direct care to residents will be posted daily for each shift in a prominent location accessible to residents and visitors and in a clear and readable format. To implement this, the posting will include the name of the facility, date of posting, census at the beginning of the shift, twenty four (24) hour shift schedule, shift for the information is posted, type (registered nurse, licensed vocational nurse, certified nursing assistant) and category (licensed or no-licensed) of nursing staff working for that shift, the actual hours worked for that shift for each type and category, and the total number of licensed and non-licensed nursing staff working for the posted shift. The facility failed to ensure staffing information was posted and updated daily, at the beginning of each shift, in a prominent place readily accessible to residents and visitors. As a result, residents and visitors were unaware of the total hours of nursing staff providing direct care to the residents per shift and if there was staff shortage. The above violations had a direct relationship to the health, safety, and security of all residents.