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 each day, seven days a week, as required by policy and regulation. Review of employee timecards over a period of approximately one month revealed multiple days with either no RN coverage or less than the required eight hours of RN coverage. Specific dates were identified where RN coverage ranged from zero to just over five hours, and on some days, there was no RN present at all. Interviews with staff confirmed that there were multiple days without adequate RN coverage, and that the RN on duty did not always work the full eight hours required. Additionally, the facility did not have a full-time Director of Nursing (DON) for nearly a month. Staff interviews and facility records indicated that the DON position was vacant from one date to another, and although a corporate DON was present intermittently, this did not meet the full-time requirement. The Assistant Director of Nursing and the administrator both acknowledged the absence of a full-time DON and the lack of consistent RN coverage during this period. The facility census during this time was 25 residents.