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P5530

LPN Staffing Deficiency on Day Shift

Kittanning, Pennsylvania Survey Completed on 12-20-2024

Penalty

No penalty information released
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The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.

Summary

The facility failed to meet the regulatory requirement of providing a minimum of one Licensed Practical Nurse (LPN) per 25 residents during the day shift on December 7, 2024. A review of the facility's census data and nursing time schedules from November 24, 2024, through December 7, 2024, and December 13, 2024, through December 19, 2024, revealed a staffing shortage on the specified date. The census on December 7, 2024, was 88 residents, necessitating 3.52 full-time equivalent (FTE) LPNs, but only 3.18 FTE LPNs were present. During an interview on December 20, 2024, the Director of Nursing confirmed the facility's failure to provide the required LPN staffing level, with no additional higher-level staff available to compensate for this deficiency.

Plan Of Correction

The residents had no negative outcome from not meeting a minimum of one LPN on one shift. We are working on a relationship with a local school to try to procure staff. The DON or designee will provide the staffing coordinator with education on the Pennsylvania staffing requirements. Staffing coordinator or designee will audit the ratios daily times 4 weeks, and monthly times 1 month. Audit results will be reviewed through the monthly QAPI process/meeting.

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