Failure to Designate Full-Time RN as Director of Nursing
Penalty
Summary
The facility failed to designate a Registered Nurse (RN) to serve as the Director of Nursing (DNS) on a full-time basis, as required by regulation. Interviews with the administrator and staff revealed that the interim DNS, an RN, was primarily focused on MDS (Minimum Data Set) coordination duties and not consistently performing DNS responsibilities. The interim DNS stated that while they worked a 40-hour week, their main focus was on MDS tasks, and most DNS duties were handled by an LPN/Assistant Director of Nursing. The administrator confirmed that the interim DNS was available to work 40 hours per week as DNS if needed, but there was no documentation provided to support that the DNS duties were being fulfilled on a full-time basis. Payroll data for the interim DNS was requested but not provided, and staff interviews indicated that the LPN/ADON was the primary contact for after-hours emergencies and incident reviews. The lack of a full-time RN DNS resulted in the absence of required RN oversight for care provided to residents. No nurse staffing waivers were in place at the time of the survey.