Failure to Provide Required RN Coverage and Full-Time DON
Penalty
Summary
The facility failed to provide a registered nurse (RN) on duty for at least eight consecutive hours per day, seven days a week, as required by their policy and federal regulations. Review of the nursing staff schedules for the entire month showed multiple days with no documentation of RN coverage, including extended periods where no RN was present at all. Additionally, there was no documentation of hours worked by the Director of Nursing (DON) for the entire month. The interim DON, a corporate regional nurse, was only onsite two days per week and sometimes only one day, and was also responsible for another facility. The facility was unable to borrow an RN from another location and instead used an LPN for coverage, which did not meet the regulatory requirement for RN presence. Interviews with the administrator and the interim DON confirmed the lack of consistent RN coverage and the absence of a full-time DON. The interim DON acknowledged the facility was out of compliance and described her limited onsite activities, which included monitoring medication orders, administration, documentation, and wound care instructions. There was no indication that any other RNs were available to meet the required coverage, and the interim DON did not keep a record of her hours worked at the facility.