Failure to Maintain Required RN Coverage
Penalty
Summary
The facility failed to provide registered nurse (RN) coverage for at least 8 consecutive hours per day, 7 days a week, as required by federal regulation CFR 483.35(b)(1). Review of nursing staff schedules for February, March, and April 2025 revealed that there was no 8-hour consecutive RN coverage on two days in March and one day in April. The deficiency was identified through examination of staffing records, which showed gaps in RN coverage on specific dates. Interviews with the DON, administrator, and human resources officer confirmed ongoing challenges in hiring and retaining RNs to meet the required coverage. The DON stated that the scheduler attempted to fill open shifts and notified management of any call-ins or unfilled shifts, and that an RN was on call or could be assigned as needed. The administrator and HR officer described efforts to recruit RNs through various channels, including online job postings and local advertisements. Despite these efforts, the facility was unable to ensure consistent RN coverage as required by policy and regulation.