By Jerri Lynn Ward, J.D., Garlo Ward, P.C.
Applies to all nursing facilities
Posted September 25, 2002
Meeting state standards for resident-to-staff ratio is no longer enough to ensure compliance with Medicare regulations requiring facilities to provide sufficient nursing services “to attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident.”
A new decision by the Departmental Appeals Board (DAB) in Westgate Healthcare Center vs. CMS (2002 No. 1821) clearly says that a facility must evaluate resident needs at the facility and provide the necessary staffing based on these needs. Westgate Health Care Center was held liable for nearly $300,000 in civil monetary penalties because the facility had only one certified nursing assistant on duty overnight in the dementia care unit with 11 residents. While Westgate did meet state staffing levels, surveyors and CMS felt that another nurse was needed because a number of the residents had a tendency to wander throughout the night and some had fallen on separate occasions. The deficiency was cited at an immediate jeopardy level.
When assessing resident needs to determine appropriate staffing levels, be sure to consider the facility layout, as this was another factor used by surveyors and CMS to justify the need for additional staffing in the Westgate dementia unit.
The DAB also rejected the compliance argument used by Westgate that the facility had previous surveys in which surveyors did not cite the facility for inadequate staffing levels.
All information in this article is informational only and is not legal advice. Should you have any questions or a situation requiring advice, please contact an attorney.
Copyright 2004 by Garlo Ward, P.C., all rights reserved
Austin, Texas 78752-3714 USA
Telephone: 512-302-1103
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Email: Info@Garloward.com
