Failure to Provide Required RN Coverage
Penalty
Summary
The facility failed to ensure that a registered nurse (RN) was on duty for eight hours a day, seven days a week, for two consecutive quarters. Payroll-based journal (PBJ) data review revealed multiple days across July, August, September, October, November, and December where there was no documented eight-hour RN coverage. Specifically, there were five days in July, two in August, six in September, two in October, one in November, and seven in December without the required RN coverage. During an interview, the director of nursing and chief executive officer confirmed the lack of eight-hour RN coverage on these days. Additionally, the facility's assessment regarding RN coverage did not specify the amount of RN hours that would have been provided. The deficiency was identified based on the absence of required RN coverage for a total of 23 days within the specified period. The facility had applied for and received an RN waiver for the eight-hour per day coverage requirement, but this waiver was not in effect during the period when the deficiency occurred.