ANCHORAGE, AK - A recent inspection at Polaris Extended Care revealed significant understaffing issues that resulted in residents missing essential care services, including scheduled showers and therapeutic exercises, according to a July 2024 state survey.
Severe Staffing Deficiencies Impact Daily Care
The inspection documented concerning staffing patterns at the 920 Compassion Circle facility, where administrators implemented a system using just one certified nursing assistant (CNA) per cottage. This staffing model created significant gaps in care delivery, with periods where no cook, nurse, or CNA was available in certain areas of the facility.
One resident interviewed during the survey expressed frustration with the situation, stating "This is unacceptable" when discussing how staffing shortages prevented regular shower schedules. The resident explained that "One CNA with 12 people is a lot" and noted that when staff were unavailable, replacements had to be pulled from other cottages, creating a domino effect of care disruptions.
The resident's care plan specifically required assistance with range-of-motion exercises to all extremities, performed 3-5 repetitions twice daily, as well as bathing assistance using specialized equipment including a Carendo shower chair and ceiling lift with blue sling. These therapeutic interventions are medically necessary components of care that help maintain mobility, prevent muscle contractures, and ensure proper hygiene.
Medical Significance of Missed Care Services
When nursing home residents miss scheduled showers and therapeutic exercises, the health consequences can be substantial. Regular bathing is not merely about comfort - it prevents skin infections, pressure ulcers, and other dermatological conditions that can become life-threatening in elderly populations. For residents with limited mobility, maintaining skin integrity is particularly critical.
Range-of-motion exercises serve equally important medical functions. These therapeutic activities help prevent joint contractures, maintain circulation, and preserve whatever functional mobility residents retain. When performed consistently as prescribed, these exercises can slow physical decline and maintain quality of life. Missing these interventions can lead to accelerated loss of function and increased dependency.
The facility's staffing model of one CNA per cottage appears inadequate given the complex care needs documented in residents' care plans. Industry standards typically require higher staff-to-resident ratios, particularly when residents require assistance with activities of daily living and therapeutic interventions.
Breakdown in Care Plan Implementation
The inspection revealed a significant gap between documented care plans and actual service delivery. Resident #39's baseline care plan, printed during the survey period, clearly outlined specific requirements for twice-weekly showers on Tuesdays and Fridays, along with twice-daily range-of-motion exercises. However, the resident reported frequently missing these scheduled services due to insufficient staffing.
This represents a failure in care plan implementation - a fundamental requirement in nursing home operations. Federal regulations mandate that facilities develop comprehensive care plans based on individual resident assessments and then provide services according to those plans. When staffing limitations prevent this implementation, it constitutes a regulatory violation with direct impact on resident wellbeing.
The resident's care plan also included specific instructions for equipment use and gender preferences for personal care, indicating a thorough assessment had been conducted. The failure to execute these carefully developed plans suggests systemic operational problems rather than isolated incidents.
Systemic Operational Challenges
The inspection findings indicate broader operational issues beyond individual care plan failures. The resident noted that medical staff availability was also problematic, mentioning that "The doctors are gone too" and that administrative leadership was aware of the staffing challenges. This suggests the problems extended beyond nursing staff to include physician coverage and overall facility management.
Such widespread staffing issues can create a cascade of care quality problems. When CNAs are overwhelmed with patient loads, they may rush through necessary care procedures or skip non-emergency services. This can lead to medication errors, inadequate monitoring of resident conditions, and failure to identify emerging health problems.
Additional Issues Identified
The inspection documented violations related to resident choice and scheduling flexibility, with residents unable to request additional shower opportunities beyond the minimum twice-weekly schedule. The survey also revealed concerns about therapeutic exercise completion and the impact of staff shortages on overall care delivery consistency.
The facility's response to these staffing challenges - pulling staff from other cottages - created additional operational disruptions that affected care quality across multiple residential areas within the facility.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Polaris Extended Care from 2024-07-19 including all violations, facility responses, and corrective action plans.
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