Failure to Provide Full-Time Administrative and RN Coverage
Penalty
Summary
The facility failed to provide administrative oversight and required RN coverage, resulting in a lack of full-time administration and nursing supervision for an extended period. The facility was without a Director of Nursing (DON) or RN coverage for approximately three weeks, during which time the Administrator frequently assumed the role of charge nurse for both day and night shifts. Interviews with staff, including LPNs and CNAs, confirmed that there was no RN present in the building during this period, and the Administrator was often observed performing multiple roles, including charge nurse, social worker, and Administrator. The facility's own policies required RN coverage for at least 8 consecutive hours per day, 7 days a week, and designated a full-time DON, but these requirements were not met. Review of the facility's daily schedules and staff interviews corroborated that the Administrator regularly covered nursing shifts due to the absence of RNs, and there was no documentation to prove that RN coverage was provided as required. The Administrator was unable to provide proof of RN coverage or evidence of dedicating 40 hours per week to administrative duties. Additionally, a Payroll Based Journal (PBJ) was requested by the surveyor but was not provided. The lack of administrative and RN presence had the potential to affect all 56 residents in the facility.