Failure to Provide Required RN Coverage
Penalty
Summary
The facility failed to ensure that a registered nurse (RN) was scheduled for at least eight consecutive hours a day, seven days a week, as required. Review of the Payroll-Based Journal (PBJ) Staffing report for the first quarter of 2025 revealed several staffing concerns, including a one-star staffing rating, excessively low weekend staffing, and no RN hours reported. Examination of the licensed staff schedule and daily timecard logs confirmed that there was no consecutive eight-hour RN coverage on specific dates, and there was no RN coverage at all on two identified days. Interviews with the administrator and health unit coordinator (HUC) revealed that both were responsible for scheduling and acknowledged difficulties in maintaining RN coverage due to call-ins and scheduling challenges. They confirmed that on the days in question, there was no RN coverage, and also stated that having RN coverage is a requirement for skilled nursing. Additionally, when requested, the facility was unable to provide a staffing policy. This deficiency had the potential to affect all 35 residents residing in the facility.