Failure to Provide Required RN Coverage
Penalty
Summary
The facility failed to provide the services of a Registered Nurse (RN) for eight consecutive hours a day, seven days a week, as required. On August 2, 2025, the only RN scheduled was the Assistant Director of Nursing, who was documented to work from 2:00 am to 6:00 am, resulting in four hours of RN coverage instead of the required eight. There was no corresponding timecard to confirm that the RN actually worked those hours. Another RN was initially listed on the schedule but was later confirmed not to have worked due to illness. The Administrator, who is also an RN, believed she may have covered the remaining hours but could not provide documentation or medical record entries to confirm this. The Director of Nursing also could not confirm that the Administrator worked as a floor nurse on that date. The Director of Nursing reported ongoing difficulties in hiring RNs due to non-competitive wages, leading to reliance on agency staff and the hiring of additional CNAs to maintain direct care staffing. The facility's records indicated that only one RN shift was covered on the date in question, and there was no evidence of RN coverage for the required eight consecutive hours. At the time of the survey, the facility had 70 residents, all of whom were potentially affected by the lack of required RN coverage.