Staffing Deficiencies in Nurse Aide Ratios
Penalty
Summary
The facility failed to meet the required nurse aide (NA) staffing ratios as mandated by regulations effective July 1, 2024. Specifically, the facility did not maintain the minimum staffing levels of one NA per 10 residents during the day shift, one NA per 11 residents during the evening shift, and one NA per 15 residents overnight. This deficiency was observed over a 14-day period from January 1, 2025, to January 14, 2025. During this time, the facility was short-staffed on eight days for the day shift, two days for the evening shift, and six days for the overnight shift. The census of residents varied slightly, ranging from 82 to 86 residents, but the facility consistently failed to provide the required number of NAs to meet the staffing ratios. The specific shortages included instances where the number of NAs working was below the required number, such as on January 1, 2025, when only 7.09 NAs worked during the day shift, while 8.60 were required for a census of 86 residents. Similar shortages were noted on other days and shifts, with the most significant shortfall occurring on the overnight shift on January 4, 2025, where only 3.40 NAs worked, while 5.60 were required. The Nursing Home Administrator confirmed these staffing deficiencies during a telephone interview, acknowledging the facility's failure to meet the minimum NA ratio requirements on the specified dates and shifts.
Plan Of Correction
The facility acknowledges that, as of 1/21/2024, we are unable to change the results of the staffing ratio of nurse aides of one NA per 10 residents on the day shift for eight of 14 days reviewed (1/01/25, 1/02/25, 1/04/25, 1/05/25, 1/06/25, 1/07/25, 1/11/25, and 1/13/25); failed to ensure a minimum of one NA per 11 residents for the evening shift for two of 14 days reviewed (1/05/25, and 1/06/25); and failed to ensure a minimum of one NA per 15 residents for the overnight shift for six of 14 days reviewed (1/04/25, 1/05/25, 1/07/25, 1/09/25, 1/12/25 and 1/14/25). The upcoming schedules are created by the scheduler and reviewed with the Director of Nursing (DON) and Administrator for approval. Instruction has been provided to the DON, Scheduler, and Nursing Supervisors to ensure that they know how staffing ratios are met in creating schedules and deal with call-offs. Oakwood has advanced a recruitment and retention effort to entice additional employees to us and keep the ones that we hire. The facility has also acquired agency staff to augment our staff. Bonuses and incentives are offered to staff who pick up shifts and stay overtime. The Administrator performs a spot audit of schedules versus actual hours of care to track adherence to regulations. This will be applied to at least three days a week to ensure that staffing ratios are within prescribed parameters. The results of the audits will be provided to the Quality Assurance and Performance Improvement (QAPI) Committee for the next three meetings.