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NY State Tag

Failure to Sign Required Forms for Criminal History Checks

Plattsburgh, New York Survey Completed on 01-17-2025

Penalty

No penalty information released
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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.

Summary

The facility failed to comply with the requirements for obtaining criminal history information for new employees, as mandated by 10 New York Codes, Rules, and Regulations section 402.5(c). Specifically, the facility did not have a facility Authorized Person sign the Acknowledgement and Consent Form for Fingerprinting and Disclosure of Criminal History Record Information before requesting criminal history record checks. This deficiency was identified for five new employees, including a Certified Nurse Aide and three Nutrition Service Workers. The lack of documented evidence of the required signatures was confirmed during a recertification survey, and the Director of Employee Relations acknowledged the oversight during an interview.

Plan Of Correction

Plan of Correction: Approved February 18, 2025 1. No resident was affected by alleged deficient practice. 2. Other residents have the potential to be affected by alleged deficient practice. 3. All prior Criminal History Record Check forms have been audited for signature. Those without signature are being reviewed with signatory for correction. B. Workflow and Human Resource system configuration has been updated to require written signature. C. Policy updated to highlight signature requirement. Authorized Human Resource employee who completed task has been reeducated by Human Resource Director. Two additional Human Resource employees have been set up with access through Criminal History Record Check and trained by Human Resource Director to support this work. D. A check system has been put in place, completed by a second person, to ensure all forms are verified for accuracy. 4. Human Resource Director will audit 100% of completed forms for past three months and for new hires. B. The results of all audits will be presented at the monthly Skilled Nursing Facility Quality Assurance Performance Improvement for further recommendations. 5. Human Resource Director is responsible for the accuracy of the process. HR Position Coordinators are responsible for completing the task.

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