Failure to Provide Required RN Coverage
Penalty
Summary
The facility failed to ensure the presence of a Registered Nurse (RN) for at least 8 consecutive hours a day, 7 days a week, as required by Nebraska Revised Statute 71-6018.02(2)(a). Record reviews of Payroll-Based Journal Staffing Data Reports and facility-provided timecards revealed multiple days within several months where there was no evidence of RN coverage for the required hours. Specifically, the facility lacked RN hours on several dates, including 8/10/2024, 8/11/2024, 9/22/2024, 2/8/2025, 2/15/2025, 2/16/2025, 4/5/2025, 4/6/2025, and 4/12/2025. These findings were confirmed through interviews with facility staff, including the Nurse Consultant and the Nursing Home Administrator. The facility had a census of 45 residents at the time, and the absence of RN coverage was attributed to factors such as vacations and unexpected staffing turnovers. The process in place for ensuring RN coverage involved scheduling an RN for at least 8 consecutive hours daily and attempting to find replacements in the event of callouts or shortages. Despite these procedures, the facility was unable to provide documentation of RN coverage on the identified dates, resulting in noncompliance with the regulatory requirement.