Failure to Provide Required RN Coverage
Penalty
Summary
The facility failed to provide a Registered Nurse (RN) on duty for at least eight consecutive hours each day, seven days a week, as required. Payroll Based Journaling (PBJ) reports for Fiscal Year 2024 indicated that on 74 days, the facility did not have an RN present for the required duration. Further review of time clock and payroll data confirmed that only seven days within the year had full RN coverage, and from October 2024 to March 2025, there were 44 days without the mandated RN coverage. The facility's own monthly nurse schedules and RN clock-in/clock-out times corroborated these findings. Interviews with administrative staff revealed that RN coverage was primarily provided by the administrative nurse and a corporate float RN, but consistent coverage, especially on weekends, was not achieved. The facility had ongoing efforts to recruit additional RNs, but had not been successful in filling the position. The facility's policy required an RN to be present for at least eight consecutive hours every 24 hours, seven days a week, but this standard was not met for a significant number of days, placing residents at risk of decreased quality of care.