DNS Served as RN Supervisor During Staffing Shortages
Penalty
Summary
The facility failed to ensure that the Director of Nursing Services (DNS) did not serve as the nursing supervisor, as required when the average daily census exceeds 60 residents. Review of facility documentation showed that on multiple occasions, following RN Supervisor call-outs, the DNS assumed the role of RN Supervisor for various shifts, including night, day, and evening shifts. The DNS confirmed during an interview that she had served as the RN Supervisor on these occasions and could not recall how many additional shifts or hours she had covered in this capacity since becoming the DNS. The DNS stated that she took on these additional supervisory shifts to meet resident needs after staff call-outs. The facility's policy assigns the DNS responsibility for determining staffing numbers and assignments, with the staffing coordinator tasked with maintaining adequate coverage. The report also notes that the facility had recently hired additional supervisors and per diem nurses to improve supervisor coverage, but these actions occurred after the identified incidents.