- Date
- 4/30/2025
- Report number
- CALMS - 00089172
- Type
- Licensing Violation
- Level
- 2 - Minor harm or potential for moderate harm
- Allegation
- Failed to use an ABST
- Result
- Substantiated
- Findings
- Based on interview and record review, conducted during a site visit on 09/12/25, the facility's failure to have a fully implemented and updated Acuity-Based Staffing Tool (ABST) was substantiated. Findings include, but are not limited to:
A review of the posted staffing plan indicated the following:
· Day shift: nine direct care staff;
· Swing shift: nine direct care staff; and
· Night shift: three direct care staff.
A review of staffing schedules dated 04/24/25 through 04/30/25 indicated the following:
· Schedules unavailable or not provided for 04/26/25-04/27/25.
· Facility was short-staffed by one direct care staff on swing shift for 04/24/25, 04/25/25, 04/28/25, and 04/30/25.
In separate interviews, Staff 1, Staff 2, Staff 3, Staff 4, and Staff 5 stated the following:
· Not enough staff to do two-hour checks;
· Call lights could take 45 minutes to an hour;
· Laundry and dishes were not getting done;
· Staffing was off because the ABST (Acuity-Based Staffing Tool) was off;
· Call lights were not being monitored in the past unless residents brought up a concern; and
· Showers were not getting done.
The facility failed to have an Acuity-Based Staffing Tool (ABST) that accurately reflected the resident population, their needs, and all required Activities of Daily Living (ADL). Inconsistencies were identified between the resident roster, care plans, and the data entered into the ABST. Facility was not staffing to the levels as indicated by the ABST to meet the scheduled and unscheduled needs of residents. An investigation determined this is a violation of Oregon Administrative Rules.
Corrective Action taken on related allegation.