Other·January 18, 2023

Class B Citation - Nursing Services Citation F727, §483.35 (b) (1) except when waived under paragraph (e) or (f) of this section the facility must use the services of a registered nurse for at least 8 consecutive hours a day, 7 days a week. The REQUIREMENT is not met as evidenced by: Citation During multiple observations at the facility on 12/5/2022 from 8:30 a.m. to 4:00 p.m., 12/6/2022 from 8:00 to 4:00 p.m., 12/7/2022 from 8:30 a.m. to 4:00 p.m., 12/8/2022 from 8:30 a.m. to 2:00 p.m. and 12/9/2022 from 8:30 a.m. to 2:00 p.m., there were no registered nurse (RN) available. A review of the facility's Daily Staffing Sheet dated 12/1/2022 to 12/9/2022, indicated the nurses who worked on 12/3/2022 to 12/9/2022, on all three shifts, were licensed vocational nurses (LVN). During an interview with the Director of Staff Development (DSD) on 12/9/2022 at 10:28 a.m. the DSD confirmed the facility's director of nursing (DON) who was an RN, was on vacation. The DSD confirmed there were no RN coverage since 12/3/2022. The DSD stated, they only have one RN scheduled every Sunday, but the RN was off on 12/4/2022. During an observation on 12/9/2022 at 10:30 a.m., the DSD asked the executive director (ED) about the RN coverage. The ED stated, "Yes, we don't have an RN right now." A review of the "Licensed Nurses: Staff Schedule Sheet," dated December 2022, indicated there was no RN scheduled to work on 12/10/2022. In violation of the above cited standards, the facility failed to provide RN coverage for the dates specified above. This violation had a direct or immediate relationship to the health, safety, or security of the patients.