Failure to Provide Required RN Coverage for 8 Consecutive Hours
Penalty
Summary
The facility failed to ensure that a Registered Nurse (RN) was present for at least eight consecutive hours on one of the days reviewed. Specifically, review of the facility's Nurse Staffing Reports showed that there was no RN coverage for any shift on a particular day. During interviews, facility staff confirmed that an RN was scheduled but called out, and although the agency was contacted to provide a replacement, a Licensed Practical Nurse (LPN) was sent instead. The error was not identified until the next shift, resulting in a full day without RN coverage. The facility's policy requires sufficient staffing, including RNs, to provide nursing care in accordance with resident care plans. However, on the day in question, the absence of an RN meant that there was no RN available to assist with assessments and overall care of the residents, as confirmed by staff interviews. The deficiency was identified through document review and staff interviews, with staff acknowledging the oversight and the failure to ensure RN coverage as required by federal regulations.
Plan Of Correction
1. The facility failed to ensure there was a Registered Nurse working for at least 8 consecutive hours on 1 of 21 days reviewed. 2. All residents have the potential to be affected by this practice. 3. The Facility continues to actively fill all open Registered Nurse positions to comply with Federal Nursing Regulation to have 8 consecutive hours a day, 7 days a week. Staff requirements and facility policy were reviewed with Human Resources and the Staffing Coordinator, who were able to reiterate minimum staffing requirements. The facility will take the following measures to ensure this deficient practice does not occur. The facility will focus on recruitment and retention strategies as follows: identify vacant Registered Nurse positions daily and attempt to fill positions with current Registered Nurses staff or agency; work diligently with the Administrator, Director of Nursing, and Corporate Recruiter to advertise, recruit, and hire sufficient Registered Nurse staff. 4. The Staffing Coordinator will review schedules daily to ensure that at least 8 RN hours are scheduled and will review with the Director of Nursing. The Administrator or designee will audit the schedules weekly for 4 weeks and monthly for 2 months to ensure there is an RN scheduled for 8 consecutive hours 7 days a week. Results and audits will be reviewed at the monthly Quality Assurance Meeting for 3 consecutive meetings. Based upon the results of these audits, a decision will be made regarding the need to continue submission and reporting.