Failure to Meet Nurse Aide Staffing Ratios
Penalty
Summary
The facility failed to meet the required nurse aide to resident ratios on six out of twenty-one reviewed shifts. Specifically, on January 7, 2025, the evening shift had 7.3 nurse aides instead of the required 8 for a census of 88 residents. On January 7, 2024, the night shift had 5.17 nurse aides instead of the required 5.87 for a census of 88. On January 8, 2024, the evening shift had 5.37 nurse aides instead of the required 8.09 for a census of 89, and the night shift had 5.67 nurse aides instead of the required 5.87 for a census of 88. On January 9, 2024, the day shift had 8.3 nurse aides instead of the required 8.8 for a census of 88, and the evening shift had 6.73 nurse aides instead of the required 8 for a census of 88. No additional higher-level staff were available to compensate for these deficiencies. The Nursing Home Administrator confirmed the facility's failure to meet the required ratios during an interview on January 9, 2025.
Plan Of Correction
Preparation and/or execution of this plan of correction does not constitute an admission or agreement by the provider of the truth of the facts alleged or conclusions set forth in the statement of deficiencies. The plan of correction is prepared solely because it is by the provisions of federal and state law. The plan of correction represents the facility's credible allegation of compliance. The facility cannot retroactively correct the Nursing Assistant ratios. The facility focuses on retention of existing nursing assistants and recruitment of new nursing assistants through efforts of the staffing meetings and holding Nursing Assistant training courses in house. Bi-Weekly staffing meetings will be held to address good faith efforts towards meeting Nursing Assistant ratios. The HR/scheduler will make a good faith effort to recruit higher level staff to accommodate the ratios. Calculation of the daily nursing assistant ratios will be completed and reviewed for accuracy by the scheduler/designee. Daily ratios will be audited weekly x4 then monthly x2. The audits will be reviewed x 2 months at monthly QAPI.