{"Short_Answer__76":"KS_REM Arrowhead-SLC-2020-07","Date__77":"07\/30\/2020","Multiple_Choice__78":"Kelly Sather","Short_Answer__80":"REM Arrowhead","Short_Answer__81":"Patrick Michael Masyga","Short_Answer__82":"Pat.Masyga@TheMentorNetwork.com","Short_Answer__83":"952-922-6776","Multiple_Choice__84":"Staff Sleeping on Duty","Multiple_Choice__85":"St. Louis County","Date__86":"06\/16\/2020","Free_Text__87":"Kira was training in staff to the Springvale Program. Staff reported that Kira told her that there isn't anything that\r\nneeds to be done on overnights and that she sleeps. She then took her blanket into the tv room and slept the overnight shift leaving\r\nsomeone untrained along with 3 individuals.","Multiple_Choice__96":"1","Short_Answer__91":"Staff was asleep during overnight awake shift","True_or_False__94":"Yes","Date__97":"09\/18\/2020","Free_Text__98":"REM Springvale is an adult foster home that has four ladies who reside there. The women in the home consists of one with sever autism who requires frequent cares, one who tends to remain in her room for much of the day and two women who are in wheelchairs and require assistance for transfers. The home is typically staffed with at least two staff members during awake times to accommodate these transfer assists but may also have three staff members working during the busier times to support functions and appointments. Overnight is typically staffed with one awake staff since the one resident will tend to get up every few hours throughout the night. \r\n\r\n\r\nThis was a fairly new job for the staff member, explaining she had previously worked in a nursing facility and came to this position approximately two months prior to the incident. The hours she worked were overnight shifts, 4 on and 10 off. The hours tended up to either 11 or 12 hour days depending on whether it was a weekend or weekday. The day of the incident, she believed this to be her second or third day of the 4 days she\u2019d work in a row. The night prior she had another person during the entire overnight shift with her. This was not normal since she started working and she stated she believed they may have done this out of concern that she wouldn\u2019t show up. The night of the incident, she came in at 9:00 p.m. for her shift and realized that she would be cross-training another staff member for the overnight shift. She wasn\u2019t aware of this and recalled being \u201cthrown off\u201d by this as she still saw herself as a fairly new person to the agency. She decided that she would have the training staff shadow her as she went through and explained what she was doing and why she was doing it. She explained on a typical night shift she would start putting the ladies to bed once she arrived. She would clean the house but often times would spread this out throughout the night. She would take care of any \u201ccares\u201d that the residents required such as going to the bathroom. During the breaks in between cleaning, she would sit in the living room and watch tv. She explained she always brought a blanket as the house would get cold and she would use this while sitting in the living room.\r\n\r\nThe staff explained during that night she had a headache. She stated she was talking throughout the night with the staff who was training and mentioned having a headache. Around 3:30 in the morning, she decided to go into the other room where she could sit back and close her eyes. She states she realizes now that she could have been more direct in communicating that she was going to \u201cclose her eyes\u201d, but at the time didn\u2019t think to. She further explained thinking, \u201cthere\u2019s another person here, I\u2019m just going to close my eyes.\u201d When she got up, she realized she dosed off for approximately 15-20 minutes. She then mentioned to the trainee that she had just dosed off and then resumed work. She stated there was no other discussion on this as the work continued into the morning.","Free_Text__100":"Staff sleeping during an overnight awake shift was impacted by the staff member laying down. Staff lying down was directly influenced by the staff member having a headache and that there was another awake staff present. The other awake staff present was due to a second staff member being scheduled for the shift. The second staff member being present was impacted by the provider lining up a second staff in case the first staff member couldn\u2019t work. The lining up a second staff member was influenced due to the concern by the provider that the staff was potentially unable to make it to work. The staff member was having issues with their driver\u2019s license and there was concern that this may have prevented them from working. A valid picture ID is required for employment. \r\n\r\nWhen staff laid down, this created a situation where the conditions were conducive for sleeping. Having the conditions conducive for sleeping was established by a multitude of influences such as there was another awake staff present (thus the people in the home\u2019s supervision requirements were met), the house was quiet (all residents were asleep), the staff member laid down, and the staff member covered themself with a blanket. The staff member regularly brought a blanket to use when taking breaks due to the house being cold at night. The house being quiet and the home having natural downtime built into the night shift had a reciprocal effect on one another. Having the extra staff on shift impacted the natural downtime at the home since no major cares were needed during that time. One resident would wake up every couple of hours that did end up requiring some engagement by staff to redirect them back to bed. This need directly impacts the need for the provider to require an awake staff at night and this being calculated into the rate of care for that client through the 6790 process which sets the rate based on individual cares for the persons living in the home. The 6790 is impacted by the Community Services and Support Plan that outlines the supervision level based upon the MnCHOICES assessment.","Multiple_Choice__101":"2","Free_Text__102":"Staff lying down was directly influenced by the staff member having a headache and that there was another awake staff present. Having the conditions conducive for sleeping was established by a multitude of influences such as there was another awake staff present (thus the people in the home\u2019s supervision requirements were met), the house was quiet (all residents were asleep).","Multiple_Choice__103":"0","Multiple_Choice__105":"0","Multiple_Choice__107":"0","Multiple_Choice__109":"2","Free_Text__110":"The other awake staff present was due to a second staff member being scheduled for the shift. The second staff member being present was impacted by the provider lining up a second staff in case the first staff member couldn\u2019t work. The lining up a second staff member was influenced due to the concern by the provider that the staff was potentially unable to make it to work. Having the extra staff on shift impacted the natural downtime at the home since no major cares were needed during that time.","Multiple_Choice__111":"0","Multiple_Choice__113":"0","Multiple_Choice__115":"0","Multiple_Choice__117":"0","Multiple_Choice__119":"0","Multiple_Choice__121":"0","Multiple_Choice__123":"0","Multiple_Choice__125":"1","Yes_or_No__432":"Yes"}