Failure to Provide Required RN Coverage
Penalty
Summary
The facility failed to ensure that a Registered Nurse (RN) was on duty for eight consecutive hours each day, seven days a week, as required. Record reviews and interviews with the Director of Staff Development and the Administrator confirmed that on multiple specific dates, there was no RN coverage. The facility's own staffing plan indicated that an RN should be present from 7am to 7pm and another from 7pm to 7am, but this was not followed on the identified dates. Both the DSD and the Administrator acknowledged the absence of RN coverage and recognized the importance of having an RN available, particularly for emergencies and advanced care activities. The facility assessment outlined the need for sufficient staff with appropriate competencies to meet residents' needs, including the provision of direct care by RNs. Despite this, the documented staffing records showed gaps in RN coverage, which was confirmed during interviews and record reviews. The deficiency was identified through a review of the facility's census and direct care service hours per patient day, which clearly indicated the days without RN presence.