Failure to Provide Consistent RN Coverage as Required
Penalty
Summary
The facility failed to provide eight consecutive hours of registered nurse (RN) coverage daily for two out of thirty days reviewed, as required by regulation. Review of the nursing schedule showed that there was no RN coverage on April 20 and May 3. The facility was operating under a nurse-staffing waiver for RN coverage and relied primarily on PRN RNs and the DON to meet coverage requirements, but this was not consistent enough to eliminate the need for the waiver. The Executive Director confirmed that there was no policy regarding RN coverage and that the facility's expectation was to follow federal regulations. At the time of the deficiency, the facility had implemented a mitigation strategy to not admit residents needing RN-specific care, to have an RN on-call, and to coordinate with a local facility for RN support if needed.