Failure to Provide Required Daily RN Coverage
Penalty
Summary
The facility failed to schedule a Registered Nurse (RN) to be on duty for at least 8 consecutive hours each day, as required by regulation and the facility’s own staffing policy, for all 88 days reviewed in December 2025, January 2026, and February 2026. Review of working schedules and daily staffing sheets showed that no RN was scheduled on any day from 12/01/25 through 12/31/25, from 01/01/26 through 01/31/26, and from 02/01/26 through 02/26/26. During the survey, the Regional Nurse (V4) was the only RN present in the building, and the facility’s CMS-671 dated 02/23/26 documented that 71 residents resided in the facility. During interviews on 02/26/26, two CNAs (V23 and V22) reported that the DON (V2) and the Regional Nurse (V4) were in the facility but did not know whether they were working on the floor as nurses. At 9:45 AM on the same day, the Regional Nurse (V4) confirmed that the facility did not have an RN providing services for 8 consecutive hours a day. The facility’s policy titled “Staffing, Sufficient, and Competent Nursing,” revised August 2022, states that an RN must provide services at least eight consecutive hours every 24 hours, seven days a week, and may be scheduled for more than eight hours depending on resident acuity. Despite this policy and the presence of 71 residents, the required RN coverage was not provided during the entire review period.
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