LPN Staffing Deficiency on Night Shift
Penalty
Summary
The facility failed to meet the required licensed practical nurse (LPN) to resident ratios on one shift out of 21 reviewed. Specifically, on January 4, 2025, during the night shift, the facility had only 1.50 LPNs available, whereas the required staffing level was 1.88 LPNs for a census of 75 residents. This deficiency was confirmed through a review of the facility's weekly staffing records and an interview with the Nursing Home Administrator on January 9, 2025. No additional higher-level staff were available to compensate for this staffing shortfall.
Plan Of Correction
The facility will provide staffing ratio of one Licensed Practical Nurse per 25 residents on day shift, one Licensed Practical Nurse to 30 residents on evening shift, and one Licensed Practical Nurse per 40 residents on overnight shift. All facility residents have the potential to be affected by this practice. The facility is focusing on retaining current nursing staff. We have zero LPN openings at this time, so call offs have been the ongoing issue. The facility has implemented staff incentives for current and new staff as well as reinforcing the facility call off policy to deter unnecessary call offs. NHA or designee will educate staff on incentives and call off policy. Administrator/designee during weekday daily review of nursing schedules will audit to ensure License Practical Nurse ratios are maintained. Results of these audits will be discussed at the monthly QAPI meeting for further review and recommendations.