Inaccurate Daily Posting of Nurse Staffing Information
Penalty
Summary
The deficiency involves the facility’s failure to post accurate daily nurse staffing information when compared to the actual staffing schedules and staff who worked. A review of daily postings and nursing schedules from early January through mid-February showed that on 22 of 46 days, the posted numbers and types of nursing staff did not match the schedule. Examples included discrepancies in the number of nurse aides (NAs), medication aides (MAs), registered nurses (RNs), and licensed practical nurses (LPNs) listed as working specific shifts versus what was reflected on the daily posted nurse staffing sheets. Specific instances of inaccuracy included days when fewer or more NAs were posted than were scheduled for the 7:00 AM–3:00 PM and 11:00 PM–7:00 AM shifts, and days when the number of MAs posted did not match the schedule. On multiple dates, the postings showed different numbers of NAs on day and night shifts than the staffing schedule indicated. There were also days when the postings showed an MA working when none were scheduled, or showed no MA working when one or more were scheduled. Similar inconsistencies occurred with LPN coverage, where the posted sheets sometimes reflected more or fewer LPNs than were actually scheduled for 12-hour shifts. The report also documents repeated misclassification of one nurse’s licensure status on the posted staffing sheets. This nurse was hired as an LPN and later became an RN effective mid-January, but the staff scheduler continued to count him as an LPN and not as an RN on multiple dates after his RN licensure became effective. Interviews with the staff scheduler confirmed that she did not update the daily posted nurse staffing sheets when staff failed to report for work or when additional staff came in to cover, and that she had not adjusted the postings to reflect the nurse’s change from LPN to RN. The administrator and DON acknowledged that the staffing schedules and daily postings did not match the actual staff who worked on given shifts.
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