Inaccurate Daily Nurse Staffing Postings
Penalty
Summary
The deficiency involves the facility’s failure to ensure that daily posted nurse staffing sheets accurately reflected the actual number of nursing staff who worked on multiple reviewed days. Surveyors compared the daily posted nurse staffing sheets with the nursing staff assignment sheets and found discrepancies on four of seven days reviewed. On one day, the posted sheet showed 9 LPNs and 22 NAs, while the assignment sheet showed 6 LPNs and 27 NAs. On another day, the posted sheet indicated 8 LPNs and 24 NAs, but the assignment sheet documented 3 LPNs and 11 NAs. A third day’s posting listed 10 LPNs and 27 NAs, whereas the assignment sheet showed 11 LPNs and 23 NAs. On a fourth day, the posted sheet showed 10 LPNs, while the assignment sheet showed 11 LPNs. During interviews, the DON stated she was responsible for both creating nursing staff schedules and completing and posting the daily staffing sheets, as there was no Staff Scheduling Coordinator. She explained that if a nursing staff member called out or left early, the daily staffing posting sheet should have been adjusted, but acknowledged that this was not done. She also stated that one discrepancy between posted and scheduled LPNs occurred because an RN was counted as an LPN. The DON reported she was unaware that the posting sheets were incorrect on the identified dates and confirmed that no one reconciled the nurse staff schedules with the daily posted staffing sheets. The Administrator confirmed that the DON was responsible for posting and updating the daily nurse staffing sheets, could not explain why they were inaccurate, and stated he was not involved in the staff posting sheets but expected them to display correct information.
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