F0727

E

Failure to Ensure Required Daily RN Coverage

Saint Louis, Missouri Survey Completed on 03-26-2026

Penalty

No penalty information released

Summary

The facility failed to provide the services of a Registered Nurse (RN) for at least 8 consecutive hours a day, 7 days a week, as required by regulation and by its own Sufficient Staffing Policy dated February 2023. The policy states that the facility must provide licensed nursing staff 24 hours a day, 7 days a week, and, except when waived, must use the services of an RN for at least 8 consecutive hours daily, 7 days a week, taking into account census, acuity, and resident diagnoses. Review of staffing sheets for March 2026 showed multiple days with no RN scheduled, specifically on 3/1, 3/7, 3/9, 3/14 through 3/17, 3/21, 3/22, and 3/25, despite a census of 147 residents and a sample of 8 residents reviewed. In interviews, the DON stated she was the on-call person for the days when no RN was scheduled and believed that on-call status would count as RN coverage, acknowledging she was in the building at times on those days but not for eight hours. The Administrator stated awareness that an RN needed to be scheduled for at least eight hours a day, seven days a week, and it was noted that the salaried DON does not clock in when on duty, contributing to the lack of documented RN coverage.