F725 — Sufficient Nursing Staff
Failure to have sufficient nursing staff with the appropriate competencies and skill sets to provide the level of services needed, based on the assessments and care plans of the residents.
Reg cite · 42 CFR 483.35(a)
49 surveys in corpus
12 states
What surveyors look for
- Posted nurse staffing (DNS, RN, LPN, CNA hours) updated each shift
- PBJ (Payroll-Based Journal) submissions match the staffing observed during the survey
- Resident-to-staff ratios appropriate to the acuity mix
- RN coverage 8 hours/day, 7 days/week per federal minimum; no missed shifts
Common gotchas
- Staffing sheet shows full coverage but call lights waiting 15+ minutes
- PBJ reports show CNAs working in housekeeping or laundry when counted as direct care
- DON or staffing coordinator working the floor and counted as both
- No documented competency for travel/agency staff before they take an assignment
Real survey examples
From CMS-published 2567s in our corpus. Resident identifiers redacted.
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Many
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in
charge on each shift.
Based on facility document review, interviews, record review, and facility policy review, it was determined
that the facility failed to ensure sufficient staffing to meet the residents' needs as evidenced by not following
the facility assessment staffing guidelines for 15 of 15 shifts reviewed from [date] day shift through
[date] night shift.
The findings include:
The Facility Assessmen…
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Many
by the facility in their [date] Facility Assessment the bedside staff coverage was found lacking
coverage by either a partial or complete shift on the following days:
[date]
Day Shift: 1 RN worked 9:03AM-3:00 PM; 2 LPNs; 13 CNAs. Per facility assessment with a census of 106+
Day Shift should have 5-6 LPNs, 15 CNAs.
Evening Shift: 2 RNs (1 RN worked 3:00 PM-7:00 PM);1 LPN; 12 CNAs (1 CNA worked 3:00 PM –
7:00 PM). Per facility assessment with a census of 106+ Evening Shift should have 4 LPNs and 11 CNAs.
N…
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Many
[date]
Day Shift:1 RN worked 9:30AM-3:00 PM; 3 LPNs; 13 CNAs (1 CNA worked 9:00 AM-3:00 PM and another
worked 8:00 AM-3:00 PM). Per facility assessment with a census of 106+ Day Shift should have 5-6 LPNs
and 15 CNAs.
Evening Shift:2 RNs (1 RN worked 3:00 PM-7:00 PM);3 LPNs1 (LPN worked 3:00 PM-9:00 PM); 9 CNAs (2
CNAs worked 3:00 PM-7:00 PM). Per facility assessment with a census of 106+ Evening Shift should have
4 LPNs and 11 CNAs.
Night Shift: 1 RN; 2 LPNs; 6 CNAs. Per facility assessment with a census of 10…
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Many
During an interview on [date] at 10:49 AM, Resident's family member stated, the facility was
always short staffed and always made excuses. Resident's family member also indicated facility staff
left the resident lying in a urine-soaked bed with a full diaper. Resident's family member stated staff
changed the brief but left the bed soaking wet. The family member reported they checked that when they
first arrived. The family member had mentioned to the nurses how soaked the bed was and was told, if you
get the re…
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Many
changes to the system. The DON reported in the last six months; the facility had experienced low staffing.
She also reported some residents had been wet at shift change but did not have adverse effects from these
incidents.
During an interview on [date] at 4:59 PM, the Administrator verified direct care staff as someone that
had a certification or license and took direct care of the residents. The Administrator reported they have had
grievances on staff starting their shift with residents that had wet briefs an…
Accepted POC examples
Real accepted-POC examples for this F-tag are not yet in the open corpus. The POC drafter above generates a structurally correct draft from CMS S&C Letter 13-21's four-question schema — edit it to fit your facility's specifics before submission.
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