F0727

F

Failure to Maintain Required RN Coverage and Full-Time DON

Kewanee, Illinois Survey Completed on 01-06-2026

Penalty

18 days payment denial

Summary

The facility failed to provide RN services for at least eight consecutive hours daily, seven days a week, and failed to employ a full-time DON to oversee the nursing department. The facility’s Director of Nursing job description dated 7/2023 states that the DON is responsible for planning, organizing, developing, and directing the overall operation of the nursing department in accordance with applicable regulations to ensure quality care. The facility assessment dated 1/4/2026 documents that a DON is required to meet residents’ needs. A list titled “Days without RN coverage as of 1/5/26,” provided by the Administrator, showed there was no RN coverage on 12/10/25, 12/14/25, 12/25/25, 12/27/25, 12/28/25, and 1/2/26. The Administrator confirmed there was no RN coverage on those dates and acknowledged the requirement for a minimum of eight consecutive hours of RN coverage seven days a week, further stating that the facility was having difficulty obtaining RN coverage and that the company did not allow the use of agency RNs.

The facility also did not have a full-time DON. The Administrator identified a Regional Nurse as the current interim DON and stated that this individual was in the building only about twice a week, a practice that had been in place for approximately one to one and a half months while the facility searched for a permanent DON. The interim DON provided a list of days worked in December 2025, documenting presence in the facility on only six specific dates and confirming that they were at the facility only one to two times per week, although they reviewed the 24-hour nursing report daily. CMS Form 671 dated 1/4/26 and signed by the Administrator documented that 53 residents resided in the facility at the time these deficiencies occurred.