Failure to Meet LPN Staffing Ratios
Penalty
Summary
The facility failed to meet Pennsylvania State minimum nursing staffing regulations for Licensed Practical Nurses (LPNs) across multiple shifts from November 29, 2024, to December 5, 2024. Specifically, the facility did not maintain the required LPN-to-resident ratios on several occasions. On the day shift of November 29, 2024, there were 79 residents with only 3.0 LPNs, falling short of the required 3.16 LPNs. Similar deficiencies were noted on the night shift of November 30, 2024, with 79 residents and only 1.0 LPNs, not meeting the required 1.98 LPNs. These staffing shortfalls continued on various shifts throughout the week, including both day and night shifts on December 1, 2024, and evening and night shifts on December 3, 2024. The report further details that on December 4, 2024, the facility had 82 residents with only 2.66 LPNs on the day shift, not meeting the required 3.28 LPNs, and similar deficiencies were observed on the evening shift. On December 5, 2024, both day and night shifts were understaffed, with 82 residents and only 2.66 LPNs during the day and 81 residents with 2.00 LPNs at night, failing to meet the required ratios. These findings were confirmed during an interview with the Nursing Home Administrator and Director of Nursing on December 9, 2024, where it was acknowledged that the facility did not comply with the state staffing regulations.
Plan Of Correction
Staffing ratios cannot be corrected for dates as this is past occurrence and facility will need to hire more LPN staffing to meet staffing ratio regulation. Calculations of shift LPN ratios will be completed and reviewed daily for accuracy by the scheduler and DON to assure enough LPN coverage is scheduled to meet the ratios. The facility continues to put forth efforts to recruit and retain new nursing staff members. This includes: pickup shift bonuses for all staff pickups effective 6/29/24 and continue at this time, new hire incentives ongoing, such as sign-on bonus, increased LPN wage matrix effective 7/9/24, and tuition assistance and reimbursement programs offered by facility for nursing degrees. Staff have been re-educated on staffing ratios and potential for mandating due to call off coverage at nurse staffing meetings held on July 24th and 25th as well as additional meetings with RN supervisors on 11/20/24. Additional Emergency Staffing Nursing Manager on Duty initiated for weekend coverage, every weekend during staffing shortages. Schedules and LPN ratios will be audited daily by the scheduler and DON/designee for 11 weeks or until substantial compliance is achieved. The results will be reported monthly at the facilities Quality Assurance Performance Improvement Meeting.