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P5520

Facility Fails to Meet Nurse Aide Staffing Ratios

Orangeville, Pennsylvania Survey Completed on 04-01-2025

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 required nurse aide (NA) to resident ratios across multiple shifts, as evidenced by a review of staffing records. Specifically, the facility did not provide the minimum required number of NAs on the day, evening, and night shifts for 18 out of 21 shifts reviewed. On the day shift, the facility consistently fell short of the required 1:10 NA to resident ratio, with staffing levels ranging from 5.66 to 7.72 NAs for resident censuses between 80 and 83. Similarly, the evening shift did not meet the 1:11 ratio, with staffing levels between 6.06 and 7.16 NAs for the same resident censuses. The night shift also failed to meet the 1:15 ratio, with staffing levels between 3.56 and 4.69 NAs. The deficiency was confirmed through an interview with the Nursing Home Administrator, who acknowledged the facility's failure to meet the required staffing levels. The report does not mention any additional higher-level staff being available to compensate for the staffing shortfall. This consistent understaffing across multiple shifts indicates a systemic issue in maintaining adequate staffing levels to meet regulatory requirements.

Plan Of Correction

Facility cannot retroactively correct this deficiency. New scheduling system in place to assist with replacing call offs and filling open shifts via automatic blasts to staff. The new scheduling system also has the ability to post open shifts to all staff including agency. Agency call offs are attempted to be replaced by the agency with additional bonus as needed. Recruitment of nursing staff will continue via facility website, Indeed, recruiting group, social media websites, local newspaper, job fairs, open house and off site recruiters. Agency utilized for open shifts. Retention efforts made with any resignation. Agency rates are reviewed weekly to ensure marketable and adjustments made as necessary. Text Blast for all open shifts. Facility recruiters have purchased list of nursing and aide staff to reach out to for recruitment. New onsite HR Director hired with extensive retention and recruitment experience. Calculation of daily PPD and shift ratios will be completed and reviewed daily for accuracy by the scheduler/back up scheduler, DON/ADON and NHA. All efforts will be made to meet PPD and staffing ratios. If call offs occur, all efforts will be made to attempt to fill that position. Daily PPD and ratios will be audited weekly x4, then monthly x2. Results to QA for review and recommendations.

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