Failure to Provide Required RN Coverage
Penalty
Summary
The facility failed to provide Registered Nurse (RN) coverage for at least 8 consecutive hours per day, 7 days per week, as required by federal regulations. Record reviews and staff interviews confirmed that on 13 out of 36 days reviewed, there was no RN coverage for the required duration. Staffing data from the CMS Payroll-Based Journal (PBJ) system and the facility's own nurse staffing sheets documented these lapses on specific dates. The Scheduling Coordinator, who had only recently started in her role, was unable to explain the lack of RN coverage for the listed dates and acknowledged awareness of the regulatory requirement. She also noted ongoing difficulties in hiring RNs. The Director of Nursing (DON) confirmed the accuracy of the PBJ report and the facility's staffing records, stating that the facility had been without a Staffing Coordinator for several months, during which time the DON managed the nursing schedule. The DON and the Administrator both cited challenges in recruiting RNs, particularly for weekend shifts, and confirmed that the facility did not use agency staff. The Administrator was not aware that the facility was not meeting the federal RN coverage requirement until the issue was brought to his attention.