Failure to Complete Annual Emergency Preparedness Training
Penalty
Summary
The facility failed to ensure that employees completed the required annual emergency preparedness education for four nurse aide employees. A review of employee education records and staff interviews revealed that Nurse Aide Employees E6, E7, E8, and E9 did not have documented training on emergency preparedness. Specifically, NA Employee E6, hired on 9/16/21, did not complete the required training between 9/16/23 and 9/16/24. NA Employee E7, hired on 10/4/12, failed to complete the training between 10/4/23 and 10/4/24. NA Employee E8, hired on 10/14/13, did not have the training documented between 10/14/23 and 10/14/24. Lastly, NA Employee E9, hired on 8/15/22, did not complete the training between 8/15/24 and 8/15/24. The Nursing Home Administrator confirmed the facility's failure to ensure the completion of the required annual emergency preparedness education for these employees during an interview on 1/24/25.
Plan Of Correction
1. The facility will ensure employees receive Emergency Preparedness 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 Maintenance Manager and Human Resources Director or designee will ensure that each employee of the facility receives Emergency Preparedness 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.