Failure to Assign and Document Charge Nurse on All Shifts
Penalty
Summary
The facility failed to ensure that a licensed nurse was designated to serve as charge nurse on all shifts, as required. Review of daily assignment sheets for three nursing units over several days revealed that no charge nurse was documented for the 3:00 p.m. to 11:00 p.m. or 11:00 p.m. to 7:00 a.m. shifts. Staff interviews confirmed that there was confusion among nursing staff regarding who was responsible for oversight during these shifts. The Director of Nursing (DON) stated that there was no designated charge nurse at night and that all nurses worked together, while the Assistant Director of Nursing (ADON) indicated that an RN on duty at night was considered the supervisor, but this was not consistently documented on assignment sheets. Further interviews with LPN staff revealed a lack of awareness about who the evening or night supervisor was, with staff unable to identify a designated leader for those shifts. The Administrator also could not confirm who was in charge, deferring to the DON. The DON acknowledged that there was not currently a licensed nurse assigned as supervisor on the evening shifts and confirmed the lack of documentation on assignment sheets. No specific residents or patient conditions were mentioned in relation to this deficiency.