(1) Effective July 1, 2023, the total number of hours of general nursing care provided in each 24-hour period shall, when totaled for the entire facility, be a minimum of 2.87 hours of direct resident care for each resident.
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Observations:
Based on a review of nursing time schedules, it was determined the facility failed to provide a minimum of 2.87 hours of direct care for each resident for one of 14 days reviewed.
Findings include:
Review of nursing schedules for 14 days from May 6 through May 19, 2024, revealed the following total nursing care hours below minimum requirements:
May 12, 2024: 2.78 care hours per resident.
In an interview on May 20, 2024, the Director of Nursing confirmed they did not meet the required minimum hours of direct care for each resident on the above day.
| | Plan of Correction - To be completed: 06/12/2024
1.) A review was completed on the days identified where the facility failed to meet staffing PPD guidelines. One (1) day identified for facility failed to provide 2.87 hours of direct care for residents on May 12, 2024.
2.) DON or administrator will complete a 4-week patient per day (PPD) look back.
3.) DON or designee will educate Nursing Schedulers/Supervisors on the PPD guidelines that went into effective on July 1, 2023.
4.) DON or designee will audit PPD 5 times per week for 4 weeks, then weekly for 4 weeks, and monthly for 3 months. Results will be reviewed in QAPI.
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