PRINTED: O4l17l2O1Ð ËORMAPPROVED STATEMENT OF DEFICIËNCIES ÀND PIAN OË CORRECTION (xr ) PRovrDEFvsuPPLrER/cLrA (x2) IDENTIFICAT¡ON NUMBER: A. BUILDING: 4OO KAWEAH DELTA MEDICAL CENTER W MINERAL KING AVE vtsALtA, cA SUMMARY STAÎËMENT OF DEFICIENCIES (EAOH DEFICIENCY MUST BE FRECEOED BY FULL REGULATORY OR LSC toENÏFytNG TNFORMATTON) rD c o411712019 STREETADDRESS. CITY. STATE, ZIP CODE NAME OF PROVIDER OR SUPPLIER (x¿) (X3) DATE SURVEY COMPLËTËO coNsTRucTloN B.WING cA040000106 PREFIX TAG MULTTPLE 93291 ID PREFIX TA6 ÞRÔVIDER,'s PLAN OF CORRECTION (EAôH CORRËCTIVË,ACTION SHOULÞ BË CROSS-REFERENêED TÔ THE APPRÔPRIATE (x6) COMPLETE DATE DEFTCTENCY) E 00c lnitialComments E 000 The following reflects the findings of the California Department of Publíc Health during the lnvestigation of ä complaint. Complalnt Nurnber: 621 852 Representing tho Department: 39602, HFEN The inspection was limitad to the specific complaint investigated and does nol represent the findings of a full inspection of the facility. 11, jvn One deficiency wâs issued for complaint number ín ãr,aillnî i= :^ tirìs; "b#v¡ PË¿å t4=Þ 621t52. E 30S E 309 T22 DlVs CH1 ART3-70217(al(12) Nursing Servíce Staff F\' # \-€t x:e¡ r, m (12) The licensed nurse-to-patient ratio in a r1 I "I I .-. t¿ill c T lËË :ofrl I I f 'Ïl ËEã r\) fl specíalty câre unit shall be 1:5 or fewer at all tlmes. Commencing January 1, 2008, the licensed nurse-to-patient ratio in a specialty care unit shall be 1:4 or fewer at all times. A specialty care unil is defined as a unit whích is organízed, operated, and maintained to provide care for a Ë O (a) c i<ìñ 'Þs, cr r '15 r -' Ë specific medical condition or a specifìc patient population, Services provided in these unlts are morê sp€clallzed to meet the needs of patients wÍth lhe specific condition or dlseass process than that whlch is required on medicai/surgical units, and is not othenruise covered by subdivísion (a), This Statute ís not met as evldênced by: tABO SÏATE R TITLE ù 1EOR11 (x6) ÞAfE ,l lfCont¡nuetion gheet of 3 ê) PRINTEÞ; O4l17l2o1e FORM APPROVED rnia SYATEMENT OF DEFICIENCIES (X1 AND PI4N OF CORRECTION ) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMtsER: Þ, cA040000106 NAME OF PROVIOER OR SUPPLIER COMPLETED c wrNs 04t17t20'ts 4OO W MINERAL KINGAVE vlsALtA, cA s3291 SUMIVIARY STAÏEMÊNÏ OF DEFICIENCIES ID (EACH DÉFICIENCY MUST BE PRECEDED BY FULL REGULÂToRY OR LSC fÞENïrytNG TNFORMATTON) PREFIX I I TAG I E 309 Continued From page (x3) DArE SURVEY STREETADDRESS, CITY, STATE. ZIP CODE I(AWEAH DELTA MEDICAL CENTER (x4) tD PREFIX TAG (x2) MULfl PLE CONSTRUCTTON A, BUILDING: PROVIDER'S PLAN OF CORREÖTION (EACH CORRECTTVEACfloN SHQULD BE CROSS-REFERENCED TO THE APPROPRIAIE (x5) COI,IFLÊïÉ DATÊ DEFTcTENCV) E 30S 1 Based 0n lnterview änd record Íoview, the facility falled t0 maintain a staffing ratio of one nurso to four patîents (1:4) on its renal specielty unit, This failure had the potentiâlto result in ineffective nursing carê for patients on th€ renal specialty unit. Findings: During an lnterv¡ew with the Ronal UnitAssistant Nurse Manager (ANM) and revíew of tho urrit's staffing documents on 2112119, at 11:10 AM, ANM stated the unlt is a renal specîalty unlt, and their staffing ratio is supposed to bo 1;4. ANM stated all nurses on lhe current d.aV s[ift had more tharr four patients. The daily unit staffing sheet ¡nd¡cäte¿ there were six Registereã Nurses (RNs) currôntly on duty, five with slx patients assigned to them. The unit's daily staffing sheets fot 214119 through 2111119 were reviewed, and indÌcated the unit was staffed ou¡t of ratio on the following dates: 214119 day shift: Three RNs had five patients each 2l4l1g night shift: Five RNs had five patients each 2l5hS day shif[ Four RNs had five patients ôech 215119 night shift: Three RNs had five patients each 216119 day shíft: Three RNs had flve patients each 216119 níght shift Four RNs had five patÌents each 217119 day shift: Six RNs had five patients each 2l7l1g night shifL Two RNs had five patients each 2l8hg day shift: Three RNs had five patients each 2l8l1g night shift: Three RNs had five pationts each 2l9l1g day shift: Five RNs had five patíents each STATE FORM 6890 1EQR11 lf contfnuatlon sheet 2 of 3 PRINTED; 0411"112019 FORMAPPRÔVED ent of Pu Cal STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (xt ) PRovtDER/suPPLtER/CLtA (x2) MULÏPLE CoNSTRUCTION IDENTIFICATION NUMBER: A. BUILDING: B, W NO c40400001 0õ NAME OF PROVIDER QR SUPPLIER KAWEATI DELTA MEDICAL CENTER (x4) rD PREFIX TA6 E 30S (X3) DATE SURVEY COMPLETED 0,411712q1fJ STREETAODRESS. GITY, STATE. ZIP CODE 4OO W MINERAL KING AVE vtsALtA, cA SUMMARY $TATEMENT OF DEFICIENCIES (EAGH DEFICIENCY MUST BE PRECEDED BY FULL REGULATORY OR LSC TDENTIFYTNG TNFORMATTQN) 93291 FROVIDER'S PLAN OF CORRECTION ID PREFIX TAG (EAct",t (x5) coRRÉcÍrvE AcÏloN sHouLD EE CROSS-REFERENGED TO THE APPROPRIATE COMPLETE DATE DEFTCTENCY) Continued From page 2 E 30S 2lgl1g night shift: Four RNs had five patíents eaoh 2111l1g day shift: Six RNs had five patíonts each 2111119 night shift: Five RNs had five patients each ANM confirmed the fíndings Durlng an lnterview wlth RN 1, on 2112119, al 12:20 PM, RN 1 stalod sho currontly has slx pat¡ents assigned to her. RN 1 stated six palients is "a bít ovenruhelrning." SÏAÏE FORM 6BS9 IEQRl1 llcont¡nuâtlon sheel 3 ôf 3 CDPH Plan of Correction Worksheet cAs 621852 on the renal specialty unìt. - Form 2567 I Hurnan Resources Department in conjunction with nunsing leadershlp is actively working with staffing agencîei to contrdct with traveler nurses and is advertising nationally forfulþtime permanent Registered Nurses positions, Partnering with localcornrnunity college nursing programs in an effort to assistwith the recruitment and employment of future RN graduates. 3) The 4North Charge Nurses are availabie to assist staff with any patiert care needs as they do not have a pat¡ent care assignrnent. Measures of Success: frcility will conduct random weekly auditd regarding the total numberof licensed nurses within a 24 hour period that ì;¡ll include both day and nþht shifts on 4 North to ensure staffing ratios of !:4 are mainta¡ned. The The audit will be overseen by the 4 ilorth Nurse ManâEeror her desþnee with ouersight by the Director of Rena/Oncology/Critical Care Services. The results of this auditwill be reviewed and honitored through the organization's quality improvement processes and ultirnately reporting to euality council. May 6, 2019 WorksheetcÀf 621852 CDPH Plan of Correction ID E 000 Staternent of Deficiency lnitial Cornrnents Provide/s Plan of Correction Response This Plan of co rrection constitutes this facility's written cornpliance for the a lleged deficlencîes cited Tlre following reflects the findings of the California Department of Public Health during the investigat¡on of a cornplaint. Complaint N Form 2567 urnber: 62L8,52 N/A However, submission of the Plan of Correction is not an adrnission that a deficiency exists orthat one was cited correctly. This Plan of Correction ¡s subrnitted to meet requirements estâbl¡shed by state and federa I law. Representing the Department: 39602. HFEN One deficiencv was written as a result of the complaint. E 309 TZZ DtU 5 CHl ART3-7 O2t7 , (a)(l2l Nursing Service Staff (12) The licensed Nurse-to-patient ratio in a specia lty care unit shall be 1:5 or Íewer at all times- Comrnencing January 1,2008, the licensed nurse-to-pâtient ratio in a specialty care un¡t shall be 1;4 orfeuver at all times, A specialty c¿re unit is defined as a unil which is orga nized, operated, and maintåíned to provide care for a specific medical condition or a specific patient population. Services provided in these units are more specÍalized to meet the needs of patients with the specific condition ordísease process than that whìch is requÍred on medica/surgicalunits, andis not otherwise covered by subdivision (a). This Statute is not me? as evidenced by: Based on Ínterview a nd record review, the facílity failed to maintain a staffing ratio of one nurse to four patients (1:4) on its renal specialty unit. This failure had the potentialto result in íneffective nursing care for patients As part of our comrnitment to comply w¡th licensed nurse to pat¡ent ratios (1:4) fewer at alltÍmes on the 4 North uni! the fullowing ast¡Dns were taken. 1) or facilitywill continue to aggressively recruit and retain lÍcensed nurses to meet our needs using the following rneasures: The The facility will continue its student Nurse lntern program for mllege work study. This prcgram is to assistthe faeÍlity with its recruitmentof local RNs. KDMC will continue its RN residency program to allow for an easier, quîcker transilion to the units for new graduates {107 new graduates have entered the prograrn over the last 12 months): The facility continues to hire RNlps (registered nurses with interim pennits). From Apríl l,zOtB- March 3t" 2019, the facility hlred 175 staff RNs in response to its increasing census and staffing vacancies. As of April 3Ð,l}tg,there are 90 Staff RN positions open throughout the facilify and 50 external applicants. The Medical/Renal4North unit currently has 6 open Staff RN positions of which there are 12 applÍcants and interviervs are being coordinated. The facility also RNs from othercountrîes, one RN from Canada will August 331 Aprìl 1,2018 through present (ongoing efforts) 20L9. ll. Zl Overall current recruitrnent activ¡ty includes adve next schedule forJune 3,2OL9. RN Recruiter proui8& updates to nurse managers with openings as well advertising opportunit¡es to increase applicant vo wee t¿30 June 3,2019