Failure to Provide Behavioral Health Training
Penalty
Summary
The facility failed to provide required behavioral health training to eight out of nine staff members, as evidenced by a review of personnel in-service training records and staff interviews. The staff members who did not receive the training included Nurse Aides, a Central Supply Employee, an Activities Assistant, a Registered Nurse, and a Licensed Practical Nurse. Each of these employees had specific hire dates, and the records showed that they did not receive behavioral health in-service education within the required timeframe after their hire dates. During an interview, the Nursing Home Administrator confirmed the lack of behavioral health training for these staff members. This deficiency was identified under the regulatory requirements of 28 Pa Code, which outlines the responsibility of the licensee, management, and staff development. The absence of documented training indicates a failure to comply with the behavioral health training requirements as stipulated by the facility's assessment and federal regulations.
Plan Of Correction
1. The facility will ensure employees receive behavioral health training on a yearly basis. 2. A full house employee file audit will be conducted to identify the training needs of each employee to ensure ongoing yearly training. 3. The Human Resources Director or designee will ensure that each employee of the facility receives behavioral health training on a yearly basis by reviewing their training courses prior to their performance appraisal due date. If the training has been inadvertently missed, the employee will be trained on the missed course prior to the performance appraisal being completed. 4. The Administrator or designee will review 5 employee files due for performance review each month to ensure yearly training is completed weekly x4 weeks. The QAPI committee will determine the need for further audits.