Staffing Deficiency Due to Inadequate Nurse Aide Coverage
Penalty
Summary
The facility failed to meet the required nurse aide-to-resident staffing ratios on multiple occasions, as evidenced by a review of nursing schedules and staffing information. On December 20, 2024, the facility had a census of 119 residents, necessitating 10.82 nurse aides for the evening shift, but only 9.37 nurse aides were available. Similarly, on December 19, 2024, with a census of 120 residents, the overnight shift required 7.93 nurse aides, yet only 7.07 were present. This pattern continued over the following days, with the facility consistently falling short of the required number of nurse aides during the overnight shifts. The deficiency was confirmed through an interview with the Nursing Home Administrator, who acknowledged that the facility did not meet the staffing ratios due to call-offs. No additional higher-level staff were available to compensate for these deficiencies, indicating a lack of contingency planning to address unexpected staff shortages. The report highlights specific instances where the facility's staffing levels were inadequate, leading to non-compliance with the regulatory requirements for nurse aide-to-resident ratios.
Plan Of Correction
1. The administrator and/or designee will conduct a review of the last 14-days of nursing schedules to determine compliance with proper nursing hours. 2. The administrator and/or designee will conduct reviews at least 5-days per week for two weeks, then 3-days per week for one month to ensure compliance. In the event of extensive call-offs, higher level nursing will staff fill, if possible. We ask for volunteers with bonuses, then in extreme cases, we will mandate and will stop admissions. We continue to recruit all levels of staff: Registered Nurses, Licensed Practical Nurses, Certified Nurse's Aides. We also have a schedule/staffing meeting each day to discuss staffing and census. We have created a shift differential for evenings and night shifts and a weekend differential - this program is for all our nursing staff. We have increased our Registered Nurse and Licensed Practical Nurse wages. We continue a bonus for: Open Shift Bonus 4hrs 8hrs Registered Nurses, Licensed Practical Nurses, Certified Nurse's Aides. Referral and Sign on Bonuses for: Registered Nurses, Licensed Practical Nurses, Certified Nurse's Aides. While we continue recruitment, we have established a Certified Nurse's Aide class through an outside contractor to develop more Certified Nurse's Aides. 3. The results of the audits, along with a Root Cause Analysis of any identified issues, will be brought to the Quality Assurance and Performance Improvement Committee for further analysis and corrective action.