Nurse Aide Staffing Deficiency
Penalty
Summary
Hermitage Nursing and Rehabilitation failed to meet the required nurse aide (NA) staffing ratios as mandated by the 28 PA Code, Commonwealth of Pennsylvania Long Term Care Licensure Regulations. The facility was unable to provide the minimum number of NAs per resident during various shifts over a 14-day period. Specifically, the facility did not meet the required ratio of one NA per 10 residents during the day shift on five occasions, one NA per 11 residents during the evening shift on six occasions, and one NA per 15 residents during the overnight shift on four occasions. This deficiency was identified through a review of the facility's nursing staffing documents and confirmed by the Nursing Home Administrator during a telephone interview. The staffing shortages were documented on specific dates, with the facility consistently falling short of the required number of NAs needed to meet the resident census. For instance, on certain days, the facility had a census of 92 residents but only staffed 8.78 NAs instead of the required 9.20 during the day shift. Similar shortages were noted during the evening and overnight shifts, with the facility failing to meet the required NA ratios, thereby not complying with the state regulations. These findings indicate a pattern of insufficient staffing that persisted over the observed period.
Plan Of Correction
Preparation and submission of this plan of correction is required by state and federal law. This plan of correction does not constitute an admission for purposes of general liability, professional malpractice or any other court proceeding. No residents were found to be negatively affected by the deficient practice of regulation. The facility will maintain 1 nurse aide for 10 residents on day shift, 1 nurse aide for 11 residents for evening shifts, and 1 nurse aide to 15 residents for night shift to meet minimum state regulation, as required and calculated by PA DOH Minimum Staffing Ratios. 1. The Administrator and/or designee will have a staffing meeting each business day morning, for four weeks to ensure the proper staff to resident ratios meet shift requirements according to current censuses. Census will be reviewed to ensure staff to resident ratio. 2. The facility will utilize administrative staff that have certified Nurse Aide certification to maintain the required ratios for the CNA, in the event of unforeseen shortage of CNA. 3. The Facility will utilize Open Shift program to make the schedule accessible to staff to see open shifts and pick them up. 4. Administrator or designees will continue to recruit potential employees by placing ads on Indeed and other recruiting mediums, networking within the community through Facebook and other social media. 5. Referral bonus will be offered to employees to encourage candidates to apply. 6. The Administrator or designee will review the staffing concerns in monthly QAPI meetings as needed. 7. Scheduler and Nursing Supervisors will be re-educated on requirements of staff in order to meet mandatory resident to staff ratios. 8. Nursing Supervisors will notify DON/ADON as soon as possible, of staff shortage needs in order to cover needs as possible. 9. Active recruitment of employees at local medical facilities that are closing will be documented. 10. All auditing of above process will be completed by NHA/DON, or designee, and documented 5 times weekly at a minimum.