Daily Staffing Grid Compliance Log

Daily inspection log for nursing home staffing by shift and resident day, comparing actual nursing hours per resident day (PPD) against the posted staffing plan. Supports staffing compliance review, PBJ alignment, and documentation for survey readiness.

Inspection Setup

• Date of staffing review recorded
  Record the calendar date and shift period being reviewed.
• Facility unit or nursing neighborhood identified
  Identify the unit, wing, hall, or facility-wide staffing grid covered by this log.
• Posted staffing plan available for comparison
  Confirm the posted staffing plan or daily staffing grid was available at the time of review.
• Resident census documented
  Enter the resident census used to calculate nursing hours per resident day.

Shift Staffing Review

• Day shift actual staffing matches posted plan within variance threshold
  Compare day shift actual nursing coverage to the posted staffing grid and note any deficiency.
• Evening shift actual staffing matches posted plan within variance threshold
  Compare evening shift actual nursing coverage to the posted staffing grid and note any deficiency.
• Night shift actual staffing matches posted plan within variance threshold
  Compare night shift actual nursing coverage to the posted staffing grid and note any deficiency.
• Licensed nurse coverage documented for each shift
  Confirm RN/LPN/LVN coverage is documented by shift as applicable to the facility plan and state requirements.
• CNA or nurse aide coverage documented for each shift
  Confirm nurse aide coverage is documented by shift and aligned to the posted staffing plan.

Hours Per Resident Day Calculation

• Total nursing hours worked recorded
  Enter total nursing hours worked for the day across all shifts and disciplines included in the log.
• Nursing hours per resident day calculated
  Calculate total nursing hours divided by resident census to determine hours per resident day.
• Calculated PPD aligns with posted staffing target
  Confirm the calculated PPD is consistent with the posted staffing plan or approved staffing target.
• Variance from posted staffing plan documented
  Record the difference between actual PPD and the posted staffing plan target.

Compliance and Documentation Quality

• Staffing variance explanation documented when applicable
  Document the reason for any staffing shortage, call-out, census change, or agency coverage variance.
• Agency or contract staff identified separately
  Confirm agency, contract, or float staff are identified separately from facility employees for PBJ alignment.
• Documentation is complete, legible, and time-stamped
  Verify the log is complete, readable, and includes time stamps or shift times for audit readiness.
• No unresolved non-conformance noted
  Confirm any deficiencies were escalated and tracked for follow-up.

Corrective Action and Sign-Off

• Corrective action entered for any staffing deficiency
  Document the immediate corrective action taken for any shift shortage or staffing plan deviation.
• Supervisor or designee review completed
  Confirm the staffing log was reviewed by the nurse supervisor, DON, or designee.
• Reference to supporting staffing record or PBJ source available