- Date
- 9/22/2025
- Report number
- CALMS - 00129546
- Type
- Licensing Violation
- Level
- 2 - Minor harm or potential for moderate harm
- Allegation
- Failed to staff as indicated by ABST
- Result
- Substantiated
- Findings
- Based on interview and record review, conducted during an investigation on 08/21/2026, the facility’s failure to use the results of an Acuity-Based Staffing Tool (ABST) to develop and routinely update the facility’s posted staffing plan and to have qualified awake direct care staff, sufficient in number to meet the 24-hour scheduled and unscheduled needs of each resident was substantiated. Findings include, but are not limited to:
A review of the facility’s ABST care times as of 09/25/2025 indicated:
- For Day shift, 4.02, or a minimum of 4.5 direct care staff;
- For Swing shift, 3.41, or a minimum of 3.5 direct care staff; and
- For Night shift, 0.97 hours, or a minimum of 1 direct care staff.
The facility’s posted staffing plan indicated:
- For Day shift, 4 direct care staff;
- For Swing shift, 4 direct care staff; and
- For Night shift, 2 direct care staff.
The posted staffing plan did not exceed the ABST hours required. The facility’s staffing schedule, dated 09/22/2025, indicated the facility was not staffing above the ABST care times to account for unscheduled needs of the residents for 1 of 3 shifts reviewed. The facility’s failure to have qualified awake direct care staff, sufficient in number to meet the 24-hour scheduled and unscheduled needs of each resident and to use the results of an Acuity-Based Staffing Tool (ABST) to develop and routinely update the facility’s posted staffing plan is a violation of Oregon Administrative Rules.