Failure to Timely Request and Support Waiver for RN DON Requirement
Penalty
Summary
The facility failed to request a waiver in a timely and complete manner when unable to meet the requirement of having a registered nurse serve as the Director of Nursing (DON). After the resignation of the previous DON, who was a registered nurse, the facility was without a registered nurse in this position for an extended period. Although the facility eventually submitted a waiver request, it did so several months after the vacancy began. The State Agency (SA) denied the initial waiver request and requested additional information to demonstrate diligent efforts to recruit appropriate personnel, evidence that a waiver would not endanger resident health or safety, and confirmation that a registered nurse or physician was available to respond to calls when licensed nursing services were unavailable. The facility did not respond to the SA's request for further information, nor did it submit an additional waiver request as instructed. During an on-site investigation, it was confirmed that the acting DON was not a registered nurse and did not meet state and federal requirements.