Failure to Maintain Full-Time Director of Nursing
Penalty
Summary
The facility failed to ensure the presence of a full-time Director of Nursing (DON), as required by regulations, which affected all 60 residents. Record review showed that the DON position was documented as vacant in the Facility Assessment. Interviews with the Administrator and the Vice President of Operations confirmed that the facility had not had a DON for approximately one month, and there were no nursing waivers in place. The Administrator was unable to specify when the previous DON left, and documentation showed that the position had been posted for hire since early May. Staff interviews revealed that the absence of a DON disrupted the chain of command among nursing staff. The Medical Records Nurse indicated that the lack of a DON had broken the chain of command for floor staff, and an LPN described the situation as stressful due to uncertainty in the absence of leadership. The DON job description outlined responsibilities including directing nursing services, care planning, and administrative functions, all of which were unfulfilled during the vacancy.