LPN Staffing Shortages on Evening and Overnight Shifts
Penalty
Summary
The facility failed to meet the required staffing ratios for Licensed Practical Nurses (LPNs) on both the evening and overnight shifts during the review period from December 15, 2024, to December 21, 2024. Specifically, on December 19 and 20, 2024, the evening shift did not meet the minimum requirement of one LPN per 30 residents, with only 3.28 and 3.21 LPNs working against the required 3.43 and 3.50, respectively, for a census of 103 and 106 residents. Additionally, the overnight shift on December 19, 20, and 21, 2024, did not meet the minimum requirement of one LPN per 40 residents, with staffing levels of 3.28, 3.21, and 2.08 LPNs against the required 3.43, 3.50, and 2.60 for a census of 103, 105, and 104 residents, respectively. The Nursing Home Administrator confirmed these staffing shortages during an interview on December 23, 2024.
Plan Of Correction
All residents received appropriate care and services to meet their needs on the identified days and there was no direct correlation to an individual resident. Residents of Warren Manor will be protected from future staff ratios below the 1:25 daylight Licensed Practical Nurse, 1:30 evening Licensed Practical Nurse, and 1:40 night Licensed Practical Nurse by a proactive preview of daily staff assignments and schedules to ensure adequate staff coverage by Director of Nursing/Designee. The Director of Nursing/designee will review the monthly schedule prior to its start date to review for adequate staffing and fill in missing shifts before giving to the staff. The nursing scheduler/designee will review projected staffing levels with the Director of Nursing/designee daily to ensure that any foreseeable staffing levels below Licensed Practical Nurse ratios are adequately covered. Charge Nurses will be educated by Director of Nursing/designee by 1/31/25 on appropriate staffing ratios and to immediately contact Director of Nursing for any day that ratios unexpectedly drop below the nurse ratio minimum for immediate resolution. Warren Manor will continue to aggressively advertise externally for the recruitment of nursing applicants to enhance current staffing levels. The facility will also review potential admissions and reconsider admissions if the facility is unable to meet minimum staffing levels. Administrative registered nurses are assigned to an on-call schedule and are available to cover shifts when foreseeable staffing levels are below the ratio levels. The facility offers extra incentives to current staff to cover extra shifts. A weekly recruiting meeting is held to address open positions. Open walk-in interview sessions will be held weekly. Licensed Practical Nurse ratios will be reviewed by Director of Nursing/nursing designee 3x's a week for a month, then weekly x3 weeks, then monthly x2 months. Results will be reported at the monthly Quality Assurance and Process Improvement committee meeting.