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F0727
E

DON Served as Charge Nurse and CNA in Violation of Staffing Requirements

Wytheville, Virginia Survey Completed on 05-07-2025

Penalty

Fine: $79,870
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The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.

Summary

The facility failed to ensure that the Director of Nursing (DON) did not serve as a charge nurse, as required. Based on staff interviews and facility document review, it was found that the DON worked as a floor nurse on nine occasions and as a certified nursing assistant (CNA) on five occasions between January and April, for a total of 14 instances. The facility has 107 certified beds with an average daily census of 98 residents. During interviews, the DON acknowledged working the medication cart at times and stated that when she or the Unit Managers were assigned to direct care duties, it was difficult to keep up with facility processes. The Administrator confirmed awareness of the issue, indicating that having the DON work on the floor was considered a last resort to ensure resident care.

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