Failure to Meet Minimum LPN Staffing Ratios
Penalty
Summary
The facility failed to meet the required minimum LPN-to-resident staffing ratios on several occasions, as determined by a review of nursing staff care hours and staff interviews. Specifically, during the day shift, the number of LPNs scheduled was below the required ratio for three days, with examples including 3.00 LPNs for 86 residents (required 3.44), 2.81 LPNs for 89 residents (required 3.56), and 3.00 LPNs for 84 residents (required 3.36). On the evening shift, the facility scheduled 2.38 LPNs for 88 residents when 2.93 were required, and on the overnight shift, 1.94 LPNs were scheduled for 88 residents when 2.20 were required. These findings were confirmed in an interview with the Nursing Home Administrator and Director of Nursing, who acknowledged that the facility did not meet the regulatory LPN-to-resident ratios on the identified days. No information about specific residents, their medical history, or their condition at the time of the deficiency is provided in the report.
Plan Of Correction
There is no evidence of any ill effect on any residents within the community due to lack of adherence to the ratio requirement for the LPN staff on these dates. Current LPN ratios are presented and reviewed at the morning leadership meeting to assure compliance in accordance with the daily DOH Staffing Hours report. Identified concerns are highlighted and discussed with management for additional planning purposes. Outliers are addressed for resolution of the current daily needs. Upon identification of continued staffing needs, immediate mass texts are sent to all current staff including full-time, part-time, and PRN. In addition, needs are posted on agency sites and one-on-one conversations are held with staff to ensure staff needs are met. If continued needs exist, the group will touch base again mid-day to ensure corrective actions have been taken. Also, during the meeting, the following 3 days are reviewed to highlight any potential upcoming outlier concerns. An audit of the DOH Staffing Hour Calculator Report will be reviewed daily for two weeks and weekly for one month at the morning meeting for presentation and discussion of any variances with the established compliance requirements and actions taken to attempt to eliminate any variances. Findings will be presented to the Quality Assurance Performance Improvement committee for recommendations, an explanation of any identified variance infractions.