Failure to Meet LPN Staffing Ratios
Penalty
Summary
The facility failed to meet the required LPN-to-resident staffing ratios during the overnight shifts on three separate occasions. Specifically, on November 26, 2024, with a census of 78 residents, the facility required 1.95 LPNs but only had 1.93 LPNs on duty. On November 27, 2024, with a census of 77 residents, 1.93 LPNs were needed, but only 1.60 LPNs were present. On November 30, 2024, again with a census of 77 residents, 1.93 LPNs were required, but only 1.05 LPNs were available. There were no additional higher-level staff available to compensate for these deficiencies. The Nursing Home Administrator confirmed the failure to meet the required staffing ratios during an interview on January 9, 2025.
Plan Of Correction
The nursing schedule will be reviewed by the scheduler and Director of Nursing to ensure that nursing assistant ratios are met prior to posting of the schedule. The daily schedule will be reviewed during the daily stand-up meeting. In the event of call-offs by staff, all other staff will be contacted to cover any open shifts to ensure ratios are met. The staffing tool audit will be completed daily for 4 weeks, then 3 times a week for 3 weeks, then 2 times a week for 2 weeks, then weekly ongoing, to ensure that nursing ratios are met for the daylight, evening, and overnight shifts. The audit will be monitored by the Director of Nursing or Designee.