(2) Effective July 1, 2023, a minimum of 1 nurse aide per 12 residents during the day, 1 nurse aide per 12 residents during the evening, and 1 nurse aide per 20 residents overnight.
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Observations:
Based on a review of nursing time schedules, it was determined that the facility failed to meet the minimum nurse aide (NA) to resident ratios for a total of 23 shifts of 21 days reviewed.
Findings include:
Review of nursing schedules for 21 days from February 4 through February 24, 2024, revealed the following:
The facility failed to meet the minimum NA to resident ratio of one NA for 12 residents on day shift (7:00 a.m. to 3:00 p.m.) on February 9, 16, 17 and 19, 2024.
The facility failed to meet the minimum NA to resident ratio of one NA for 12 residents on evening shift (3:00 p.m. to 11:00 p.m.) on February 4, 5, 6, 7, 8, 10, 12, 14, 15, 16, 17, 19, 20, 23, and 24, 2024.
The facility failed to meet the minimum NA to resident ratio of one NA for 20 residents on night shift (11:00 p.m. to 7:00 a.m.) on February 6, 16, 17, and 23, 2024.
In an interview on February 28,. 2024, at 2:00 p.m., the Director of Nursing stated that the facility failed to meet the NA to resident ratios for the days and shifts listed above.
| | Plan of Correction - To be completed: 03/19/2024
1) The findings of the nurse aide nursing staff care ratios cannot be retroactively corrected. 2. Facility will provide a minimum of one nurse aide per 12 residents during day shift and one nurse aide per 12 residents on evening shift and one aide per 20 residents overnight. 3. Scheduler will be educated on the requirements there must be a minimum of one aide per 12 residents during dayshift and a minimum of one aide per 12 residents on evening shift and one nurse aid per 20 residents overnight. 4. NHA/designee will conduct random audits to verify that nurse aide dayshift, evening shift and overnight shift ratios meet the requirements daily for 5 days, weekly for 4 weeks and then monthly for 2 months thereafter. Audit results will be presented at the QAPI meeting for review and recommendations.
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