Failure to Provide Required RN Coverage
Penalty
Summary
The facility failed to provide the services of a registered nurse (RN) for at least 8 consecutive hours per day, 7 days a week, as required. Review of Payroll-Based Journal (PBJ) staffing data and facility time sheets revealed that there was no RN coverage on a total of 19 days, including multiple Saturdays and Sundays over several months. The absence of RN coverage was confirmed for specific dates through both PBJ data and facility time sheets. The deficiency was further substantiated by interviews with the Administrator and the Director of Nursing (DON), who acknowledged the lack of RN coverage on weekends due to the loss of their Sunday nurse. The Administrator reported that efforts were being made to hire a new weekend RN and that a new nurse had recently started training. Despite the absence of an RN, the Administrator and DON stated that licensed vocational nurses (LVNs) were present and that the DON was available by phone 24/7. Facility policy reviewed indicated a requirement to comply with RN staffing regulations, but the documented staffing records showed noncompliance on the identified dates.