LPN Staffing Shortages Across Multiple Shifts
Penalty
Summary
The facility failed to meet the required staffing ratios for Licensed Practical Nurses (LPNs) across multiple shifts over a 21-day period. Specifically, the facility did not have the minimum number of LPNs on the day shift for one day, on the evening shift for six days, and on the overnight shift for thirteen days. The staffing shortages were identified through a review of the facility's nursing staffing documents and confirmed by the Nursing Home Administrator during an interview. The deficiencies were noted with specific census numbers and the corresponding number of LPNs required versus those that actually worked. For instance, on the day shift of April 15, 2025, with a census of 84 residents, only 3.31 LPNs worked when 3.36 were required. Similar discrepancies were observed on various dates for the evening and overnight shifts, with the facility consistently failing to meet the mandated LPN-to-resident ratios. These findings indicate a pattern of insufficient staffing that was acknowledged by the facility's administration.
Plan Of Correction
The facility must maintain the minimum of one Licensed Practical Nurse (LPN) per 25 residents on the day shift, one Licensed Practical Nurse (LPN) per 30 residents for evening shift and one LPN for every 40 residents on the overnight shift. To ensure that these regulatory requirements are met, the following action plan will be implemented: The scheduler was reeducated 4/28/25 to ensure that they understand the regulatory staffing requirements for Licensed Practical Nurses. The LPN schedule will be reviewed by the scheduler and Director of Nursing to ensure that LPN ratios are met prior to posting of the schedule. 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 Director of Nursing and or the Scheduler are responsible for handling call offs on the off shifts and weekends. Bonuses will be offered as an incentive for employees to cover shifts. In addition, the facility utilizes a recruitment company to attract additional staff. An audit will be developed and completed by the Director of Nursing or Designee 3 times a week for 4 weeks, then 2 times a week for 3 weeks, then weekly ongoing, to ensure that LPN ratios are met for the day, evening and overnight shifts. The audit will be monitored by the Administrator or Designee. Results of the audit will be presented at the Quality Assurance monthly meeting and recommendations will be implemented.