Inadequate Training and Competency Verification for Nurse Aides
Summary
The facility failed to ensure that Nurse Aides (NAs) received the required training and competencies before being assigned to provide direct resident care independently. This deficiency was identified for two NAs who were enrolled in a Nurse Aide Training School but had not completed the necessary modules of the Nurse Aide Training and Competency Evaluation Program (NATCEP). Despite this, they were assigned to provide independent direct care, including tasks such as bathing, toileting, transferring, feeding, personal hygiene, and grooming. The NAs were enrolled in a training program on June 18, 2024, and completed Module 1 by July 12, 2024. However, they began providing independent care on July 5, 2024, without completing Module 2 or having their competencies verified by the facility. The facility lacked records of the NAs completing the required modules, and there was no evidence of a competency process beyond a checklist. Interviews with facility staff revealed confusion and miscommunication regarding the training requirements and oversight responsibilities for the NAs. The Human Resources Director (HRD) and other staff members were unclear about the training process and the requirements for NAs to work independently. The HRD believed that after two weeks of training, the NAs could be assigned independently, but this was not in line with the facility's policy or state regulations. The Assistant Director of Nursing (ADON) and other staff members were under the impression that the NAs had completed the necessary training, but this was not the case. The lack of proper oversight and verification of training completion led to the NAs providing care without adequate preparation, placing residents at risk.
Penalty
Resources
Below are regulatory guidelines relevant to this citation:
A nursing assistant who had completed CNA coursework but had not passed the state certification test was allowed to work as a CNA for longer than the four months permitted for uncertified aides. Human Resources confirmed the staff member continued working past the allowed period, resulting in non-compliance with staff qualification requirements and potentially affecting all residents.
The facility failed to ensure nursing assistants received required training before providing direct care, affecting all 46 residents. A nurse aide in training performed duties without formal training, and several nursing assistants were hired without being on the nurse aide registry or enrolled in training programs. The facility believed they had four months to enroll aides in classes, but some worked longer without enrollment.
Unqualified Nursing Assistant Worked Beyond Permitted Timeframe
Penalty
Summary
The facility failed to ensure that a nursing assistant was properly qualified to provide resident care, as required by regulations. Record review showed that a nursing assistant was hired after completing a CNA course but had not passed the state certification test. Despite this, the staff member worked as a CNA for a period exceeding the four months allowed for individuals who have not yet obtained certification. Human Resources confirmed that the nursing assistant continued to work past the permitted timeframe without having passed the state test, resulting in non-compliance with staffing qualification requirements. This issue had the potential to affect all 142 residents in the facility, as the staff member was involved in direct resident care.
Failure to Ensure Proper Training for Nursing Assistants
Penalty
Summary
The facility failed to ensure that nursing assistants received the required training before providing direct care to residents, potentially affecting all 46 residents. Employee #145, a nurse aide in training, had not started formal training classes but was performing duties equivalent to a state-tested nursing assistant, including helping with meals, providing showers, and incontinence care. Despite having previous experience in a group home, Employee #145 had not received dementia training or training on handling aggressive behaviors. The Human Resource employee confirmed that Employee #145 was not enrolled in classes and was functioning as a state-tested nursing assistant based on the Administrator's instructions. Additionally, the facility hired several nursing assistants who were not on the nurse aide registry at the time of hire and were not enrolled in nurse aide registry classes or nursing school. These employees, including STNA #155, STNA #120, and STNA #110, had their skills checked off on orientation checklists despite not being registered or enrolled in training programs. The Human Resource employee verified that the facility believed they had four months to enroll aides in classes, and some employees had worked longer than four months without being enrolled in the NATCEP program, as the Administrator decided the timing of enrollment.
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