Observations
Based on staff interviews, and a review of facility records conducted as part of the presubmission process and during the onsite inspection, the facility failed to ensure that there were no counselor to client ratios that exceeded a 35:1 (FTE) client to counselor ratio.
Staff Person #5 was hired as a counselor on 8/17/2008.
The full-time equivalent (FTE) maximum client to counselor ratio is determined by dividing the number of clients by the FTE and rounding up to the next whole number if the number in the tenths column is greater than 0. If there is a 0 in the tenths column the number is not rounded up, and all numbers right of the decimal point are made 0.
The FTE is determined by taking the sum of all the counselor's drug and alcohol treatment hours for a work week, and dividing the number by 35.
The Staff Person #5's total drug and alcohol hours at the facility for 1 week according to the Staffing Requirements Facility Summary Report is 8 hours.
The total number of drug and alcohol clients for the counselor according to the Staffing Requirements Facility Summary Report is 19.
The 8 drug and alcohol hours divided by 35 is equal to .2285 (8/35=.2285) The FTE for the counselor is .2285.
The total number of clients for the counselor, 19, divided by the FTE, .2285, gives a number of 83.1509 (19/.2285=83.1509).
Since 83.1509 has a number greater than 0 in the tenths column, the number is rounded up to the next whole number. 83.1509 becomes 84.
Staff Person #5 has a client to counselor caseload of an 84:1.
These findings were reviewed with the facility staff as part of the licensing process.
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Plan of Correction
In order to comply with client/staff and client/counselor ratios, the caseload and hours worked by the full-time counselor working at 2 facilities within the project have been adjusted to meet applicable standards. Also, the duties of a PRN (or as needed) counselor position have been modified to provide caseload coverage and to ensure that the ratio meets applicable standards. These changes were made effective 2/27/17.
The Director of Outpatient Services will assume primary responsibility for ensuring appropriate staffing levels and for ongoing monitoring of caseloads to verify that they are within guidelines and that the client/staff and client/counselor ratios continue to meet applicable standards.
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