Failure to Provide Required RN Coverage for 8 Consecutive Hours
Penalty
Summary
The facility failed to provide the services of a registered nurse (RN) for at least 8 consecutive hours on one day during the review period. Record review of RN timesheets showed that on a Saturday, the facility only had RN coverage for 3.91 hours instead of the required 8 consecutive hours. The Director of Nursing (DON) acknowledged responsibility for ensuring RN coverage and stated that if the scheduled RN was unavailable, it was her or the Assistant Director of Nursing's (ADON) responsibility to find coverage or cover the shift themselves. However, the DON could not recall the specific circumstances that led to the shortfall on the identified day and noted that if she or the ADON had covered the remainder of the shift, it would not have been documented since they are salaried and not required to clock in. The facility's policies require RN coverage for at least 8 consecutive hours per day, 7 days a week, and include the DON's hours toward this requirement. Both the DON and the Administrator confirmed their understanding of the policy and acknowledged the potential for certain RN-specific tasks to go unperformed when coverage is lacking. The Administrator also stated that it was ultimately her responsibility to ensure compliance with RN staffing requirements and that the facility had sufficient RNs to meet the coverage requirement, despite the documented lapse.