Failure to Provide Required RN Coverage
Penalty
Summary
The facility failed to ensure that a registered nurse (RN) was on duty for a minimum of eight consecutive hours per day for four out of thirty days reviewed. Review of nursing staff schedules revealed that there was no RN coverage for the required eight hours on four specific days. The scheduling coordinator confirmed that the facility had only two RNs in-house and had to rely on agency staff to fill gaps, but sometimes only LPNs were available. The gaps in RN coverage occurred when scheduled RNs called off and replacements could not be found. Interviews with the scheduling coordinator, interim director of nursing, and administrator confirmed the lack of RN coverage on the identified days. The interim DON stated that attempts were made to fill open RN shifts in-house and through agencies, but weekends were particularly challenging. The administrator, new to the facility, acknowledged the deficiency and was not previously informed of the coverage gaps. The facility did not have a specific policy regarding RN coverage, instead following state guidelines.