(4) Effective July 1, 2023, a minimum of 1 LPN per 25 residents during the day, 1 LPN per 30 residents during the evening, and 1 LPN per 40 residents overnight.
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Observations:
Based on review of nursing schedules, review of staffing information furnished by the facility, and staff interviews, it was determined that the facility failed to ensure a minimum of one licensed practical nurse (LPN) per 40 residents during the day shift for three of 21 days (24-hour periods) reviewed.
Findings Include:
Review of facility census data indicated that on May 1, 2024, the facility census was 96, which required 2.4 LPN's during the night shift. Review of the nursing time schedules revealed that 2.38 LPN's worked the night shift of May 1, 2024. No additional excess higher-level staff were available to compensate for this deficiency.
Review of facility census data indicated that on May 8, 2024, the facility census was 97, which required 2.43 LPN's during the night shift. Review of the nursing time schedules revealed that 2.34 LPN's worked the night shift of May 8, 2024. No additional excess higher-level staff were available to compensate for this deficiency.
Interview with the Nursing Home Administrator on May 22, 2024, at 4:03 p.m. confirmed that the facility did not meet the required licensed practical nurse-to-resident staffing ratios for the days listed above.
| | Plan of Correction - To be completed: 06/17/2024
Although the facility cannot correct the staffing hours on the cited dates, efforts are continuously being made to maintain the staffing hours within regulatory guidelines.
The facility will continue with recruiting efforts, as well as, offering employment incentives in order to increase staff availability. If staffing concerns warrant, consideration will be given to placing a hold on admissions.
The Administrator/Designee has been auditing the direct care staffing ratios and will continue to audit weekly times 4 weeks, then monthly times 2 months. The audit outcomes will be presented to the Quality Assurance Committee for review and recommendations.
When there are staffing challenges, administrative staff can/will assist with mealtime, answering call bells, etc. When there is a call off, the scheduler makes contact with all staff via phone/text to find coverage. We encourage staff to take turns in staying beyond their regularly scheduled shift to cover a call offs. DON and ADON can work the floor when needed.
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