Failure to Provide Required RN Coverage
Penalty
Summary
The facility failed to ensure that a Registered Nurse (RN) was on duty for at least eight consecutive hours each day, as required by policy and regulation. Record reviews and staff interviews confirmed that on eight specific days within a 90-day period, there was no RN present to provide services. The Staff Coordinator acknowledged that no RNs were scheduled on those days and clarified that the responsibility for RN scheduling belonged to the Director of Nursing (DON). The DON admitted that maintaining daily RN coverage was difficult and that the absence of an RN could have impacted the quality of care, particularly for residents requiring specialized services such as intravenous (IV) therapy or care for peripherally inserted central catheters (PICC lines). The DON also stated that the facility did not follow its own policy and procedure regarding RN coverage. The Administrator confirmed ongoing challenges in retaining and scheduling RNs, noting that the facility had a revolving roster of RNs and was unable to consistently staff an RN each day. Both the DON and Administrator emphasized the importance of having an RN available daily, especially for residents needing advanced nursing care such as IV therapy. Review of the facility's policy indicated a clear requirement for RN coverage for at least eight consecutive hours every 24 hours, seven days a week, which was not met on the identified dates.