LPN Staffing Shortages During Night Shift
Penalty
Summary
The facility failed to meet the regulatory requirement of providing a minimum of one Licensed Practical Nurse (LPN) per 40 residents during the night shift on three specific days. A review of the nursing time schedules and facility census data from November 29, 2024, through December 3, 2024, revealed that on November 30, December 2, and December 3, the facility had staffing shortages. Specifically, on November 30, with a census of 47 residents, only 8.00 hours of LPN coverage were provided instead of the required 9.40 hours. Similarly, on December 2 and December 3, with a census of 48 residents each night, only 8.00 hours of LPN coverage were provided instead of the required 9.60 hours. This deficiency was confirmed during an interview with the Nursing Home Administrator on December 4, 2024.
Plan Of Correction
The facility failed to meet the LPN ratios on the night shift on three (11/30/24, 12/2/24, and 12/3/24) of five days during the period of 11/29/24 through 12/3/24. The state ratio regulation will be reviewed with the nurse scheduler and RNS. Ratios are reviewed daily by the DON when posting staffing sheets. Ratios are met at the time of scheduling. If there is a call off or no show, and the staffing ratios would not be met, the DON/designee will attempt to replace the call off or no show as follows: 1. Seek LPNs to volunteer from all qualified staff who are working. 2. Contact qualified employees who have made themselves available for overtime. 3. Attempt to contact employees on the next shift to come in early. 4. Use Per Diem Staff. 5. Use Temporary Staffing Agencies. In addition, the facility uses bonus incentives for internal staff, and we contract with 5 different nursing temporary agencies. The nurse scheduler will complete the DOH staffing ratio spreadsheet and turn it into NHA for review on a weekly basis. Information will be presented to the QAPI committee for review and recommendations.