Unlicensed Agency RN Provided Care Without Verification
Penalty
Summary
The facility failed to ensure that a registry RN had the appropriate competencies and valid licensure to care for residents. The RN, contracted through a staffing agency, worked multiple shifts without the facility verifying her nursing license. The issue came to light when a dietary supervisor recognized the RN as a potential candidate for a non-nursing position, prompting the DON to attempt license verification. The facility was unable to verify the RN's license through the state board, and the staffing agency could not provide verification or contact the RN. It was determined that the individual had impersonated a registered nurse using another person's license, and the facility substantiated that an unlicensed nurse had provided care. Review of facility policies and interviews with the HR Manager and DON revealed that the process for verifying licensure and competencies for registry staff was not consistently followed. The HR Manager could not locate documentation that the required checklist for verifying licensure and background checks was completed for the registry RN. The DON confirmed that there was no cross-check in place for license verification of agency staff at the time, and the facility relied on the agency to provide documentation. The facility's policy required sufficient nursing staff with appropriate competencies, but this was not ensured in the case of the registry RN.