LPN Staffing Deficiency
Penalty
Summary
The facility failed to meet the required staffing levels for Licensed Practical Nurses (LPNs) as per the regulation effective July 1, 2023. Specifically, the facility did not provide the minimum of one LPN per 25 residents during the day shift on two occasions and one LPN per 40 residents during the night shift on three occasions within a 21-day period. On November 30, 2024, with a census of 32 residents, the facility required 1.28 LPNs during the day shift but only provided 1.00 LPN. Similarly, on December 1, 2024, with a census of 33 residents, 1.32 LPNs were needed, but only 1.03 LPNs were available. No additional higher-level staff were available to compensate for these deficiencies. During the night shifts on November 22, 23, and 24, 2024, the facility also failed to meet the required LPN staffing levels. With a census of 42 residents on November 22 and 23, 1.05 LPNs were needed, but only 1.00 LPN was provided. On November 24, with a census of 41 residents, 1.03 LPNs were required, yet only 1.00 LPN was available. The Nursing Home Administrator confirmed these staffing shortages during an interview on December 12, 2024, acknowledging the facility's failure to meet the minimum LPN staffing requirements on these specific days.
Plan Of Correction
The facility will correct the deficiency. The administrator educated the Director of Nursing and the Staffing Coordinator on PA Code 211.12 as it relates to Staff to Resident Ratios and Direct Nursing Care Hours for LPN's for the following dates: 11/22, 11/23, 11/24, 11/30, and 12/01/2024. To prevent reoccurrence, the Staffing Coordinator will ensure that the correct number of LPN's are scheduled for each shift (day, evening, and night) utilizing the staffing ratio/PPD worksheet and review with the DON daily. The facility will utilize the on-call nursing staff to maintain nursing hours should the facility fall below nursing ratios on the overnight shift with an RN within a 30-minute drive from the facility. The facility will continue with weekly recruitment and retention meetings to review open positions, post open positions weekly for internal and external candidates, and offer referral bonuses to attract and retain staff. The facility will conduct audits by the DON/Designee/Scheduling Coordinator, who will review the worksheet daily for compliance for two weeks, then weekly for two weeks, and continue with weekly review and report quarterly through QAPI.