Failure to Provide Full-Time DON and Required RN Coverage
Penalty
Summary
The facility failed to provide a full-time Director of Nursing (DON) and did not ensure that a Registered Nurse (RN) was on duty for at least 8 hours a day, seven days a week, as required. According to the Administrator, the facility had been without a DON for six weeks, and although efforts were made to hire one, there was no DON present during the survey period. The staffing schedule revealed that on 8 out of 17 days, the facility did not have RN coverage for the required 8 hours, and on several days during the survey, no RN was observed on duty. The facility's own staffing policy states that an RN will be scheduled for at least one continuous 8-hour shift each day and that all department directors, including the DON, are to be employed for a forty-hour week. Despite these policies, the facility did not meet these staffing requirements, potentially affecting all 46 residents in the facility at the time of the survey.