Failure to Maintain Required RN Coverage
Penalty
Summary
The facility failed to provide the services of a registered nurse (RN) for at least eight consecutive hours per day, seven days a week, as required. Record review and interviews revealed that during four out of five months reviewed, there were multiple days when no RN was on duty for the required hours. Specifically, there was no RN coverage on one day in January, three days in February, one day in April, and two days in May. Payroll records and CMS PBJ Staffing Data confirmed these gaps, particularly on weekends, with no RN present on several Saturdays and Sundays across the reviewed months. Interviews with the Administrator and Corporate nurse confirmed awareness of the RN coverage problem, attributing the issue to staff call-ins and no-shows. The facility's own policy requires RN coverage for at least eight consecutive hours daily and designates a full-time RN as Director of Nursing. The lack of RN coverage left staff without supervisory support for RN-specific nursing activities and coordination of emergency care, as noted in the findings.