I am submitting this comment to express serious concerns regarding staffing levels and the quality of care being provided at Windsor Grove Health and Rehabilitation in Windsor, Virginia.
The facility is approximately a 100-bed nursing facility that provides memory care, long-term care, and rehabilitation services. A significant number of the residents require extensive assistance or are total-care residents who depend on staff for their activities of daily living (ADLs), including bathing, dressing, toileting, repositioning, transferring, feeding, and maintaining proper skin care.
One of my primary concerns is the staffing ratio. It is not uncommon for a single CNA to be responsible for more than 20 residents, many of whom require total care. In my view, this staffing level makes it extremely difficult, if not impossible, for CNAs to consistently provide the timely and appropriate care these residents require. When there are inadequate numbers of CNAs scheduled, basic care tasks can be delayed or missed altogether.
I have observed concerns regarding residents' overall health and skin conditions that I believe may be associated with insufficient staffing and the inability to provide adequate and timely care. Residents who are dependent on staff for repositioning, toileting, bathing, hygiene, nutrition, and other ADLs are particularly vulnerable when there are not enough caregivers available to meet their needs.
Another serious concern is the lack of assistance from licensed nursing staff when CNA staffing is inadequate. There have been situations in which LPNs, RNs, and even members of facility leadership, including the DON and ADON, have not stepped in to assist with resident care despite CNAs being overwhelmed and unable to safely meet the needs of all assigned residents. In a facility where many residents require total care, I believe all members of the care team should work together when staffing shortages occur to ensure residents receive necessary care.
I am also concerned about the response to staff members who raise concerns about staffing and resident care. Employees should be able to report concerns about resident safety, staffing levels, or missed care without fear of retaliation, intimidation, hostility, or being treated differently as a result. Staff members need to feel that they can speak up when they believe residents are not receiving the care they deserve.
My concern is not simply about the workload placed on employees. The primary concern is the impact inadequate staffing can have on vulnerable residents who cannot care for themselves and depend entirely on the facility for their basic needs, dignity, safety, and well-being.
I respectfully ask the state to thoroughly evaluate Windsor Grove Health and Rehabilitation's staffing practices, CNA-to-resident ratios, missed or delayed care, residents' skin integrity and changes in condition, repositioning and toileting practices, ADL assistance, and whether licensed nursing and supervisory staff provide appropriate assistance when staffing levels are insufficient.
I also ask that the state evaluate whether employees are able to report concerns regarding resident care and safety without fear of retaliation or other negative consequences.
These residents deserve adequate staffing and consistent, timely, and dignified care. I hope these concerns will be taken seriously and that the facility will be held accountable for providing an appropriate level of care to the residents entrusted to them.