F0850 F850: Hire a qualified full-time social worker in a facility with more than 120 beds.
C

Facility Fails to Employ Qualified Social Worker

Orchard Valley Health And RehabilitationHendersonville, North Carolina Survey Completed on 06-21-2024

Summary

The facility failed to employ a qualified full-time Social Worker (SW) as required for a skilled nursing facility with more than 120 beds. The facility, which has 134 certified beds, employed a SW who did not possess the necessary bachelor's degree in social work or a related human services field. Instead, the SW held an associate's degree in medical billing and coding and had experience working in SW positions at smaller facilities with less than 120 beds. This discrepancy was identified during a review of the facility's Social Services Director job description and confirmed through staff interviews. The Administrator, who had recently started at the facility, acknowledged awareness of the regulation requiring a qualified SW and admitted that the issue had just been brought to his attention. The Vice President of Operations (VPO) explained that the decision to hire the unqualified SW was due to difficulties in finding suitable candidates. The VPO noted that the facility's Administrator had a bachelor's degree in a human service field and that a full-time SW with a master's degree in social work at a nearby sister facility could provide supervision and support to the facility's SW.

Penalty

Inspection fine: $16,452
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The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.

Resources

Below are regulatory guidelines relevant to this citation:

See other F0850 citations
Failure to Employ a Qualified Full-Time Social Worker
E
F0850 F850: Hire a qualified full-time social worker in a facility with more than 120 beds.
Short Summary

Failure to employ a qualified full-time social worker: The facility, licensed for 120 beds, did not maintain a licensed social worker on a full-time basis after the prior social worker’s last day. The new social worker had a master’s degree and was scheduled to take the LMSW exam, but was not yet licensed. He was responsible for discharge planning, social services assessments, care plans, and grievances, and the Administrator stated she was unaware he could not serve in the role before passing the exam.

No penalty information released
tooltip icon
The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.
Failure to Employ a Qualified Full-Time Social Worker
F
F0850 F850: Hire a qualified full-time social worker in a facility with more than 120 beds.
Short Summary

Failure to employ a qualified full-time social worker. Review of the employee file showed a BS degree and a Certified Therapeutic Recreation Specialist certificate, with coursework in Recreational Therapy. The NHA stated these credentials qualified the employee for the social worker role and did not confirm that the employee lacked the required bachelor’s degree in social work or a human services field.

No penalty information released
tooltip icon
The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.
Failure to Employ Required Full-Time LSW
F
F0850 F850: Hire a qualified full-time social worker in a facility with more than 120 beds.
Short Summary

Failure to Employ Required Full-Time LSW: The facility did not have a full-time LSW even though its census exceeded 120 residents. The SSD was not a licensed social worker and confirmed the facility had been without a full-time LSW for some time. The Administrator stated two part-time social workers from other facilities were covering duties, but they did not meet the 40-hour requirement, and the SSD job description did not specify that a social work license was required.

No penalty information released
tooltip icon
The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.
Failure to Employ a Full-Time Social Worker
E
F0850 F850: Hire a qualified full-time social worker in a facility with more than 120 beds.
Short Summary

Failure to Employ a Full-Time Social Worker: A facility with 170 licensed beds did not have a full-time qualified social worker after the prior social worker left, and the staff roster showed no social worker employed. The ADM and ADON confirmed only a part-time social worker was available, while the ADM stated other staff, including the MDS nurse, were trying to cover social work duties such as resident assessments and concerns.

No penalty information released
tooltip icon
The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.
Unqualified Social Worker in Facility Over 120 Beds
F
F0850 F850: Hire a qualified full-time social worker in a facility with more than 120 beds.
Short Summary

A facility with more than 120 beds failed to have a full-time, qualified social services worker. Record review showed the social worker had a BS degree, but the file lacked evidence of a social work degree or one year of supervised social work experience under a qualified social worker. The Administrator stated the individual had a human services degree with a criminal justice major and could not provide documentation of the required supervised experience; the training documents presented did not show supervised training.

Inspection fine: $26,060
tooltip icon
The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.
Failure to Employ Required Full-Time LSW
F
F0850 F850: Hire a qualified full-time social worker in a facility with more than 120 beds.
Short Summary

Failure to employ a required full-time LSW in a facility with 151 residents. Personnel records showed the SSD was not an LSW and did not have a bachelor's degree in a human services field, and the only LSWs on record were terminated or separated from the facility. Interviews with HR, the SSD, and the Administrator confirmed the social services department had no LSW at the time of the survey, and the job description did not state the LSW requirement for a census over 120.

No penalty information released
tooltip icon
The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.
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