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F0942
F

Annual Resident Rights Training Not Documented for CNA

West Allis, Wisconsin Survey Completed on 05-01-2025

Penalty

Fine: $145,850
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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 ensure that all direct care staff received annual training on resident rights, as required. During a review of training records for five randomly selected direct care staff, it was found that one Certified Nursing Assistant (CNA) had not received documented resident rights training since 2020. The facility utilizes an online training platform, Relias, to assign and track mandatory training modules, including one on safeguarding resident rights. However, the CNA in question did not have any record of completing this required training annually, as confirmed by a review of the Relias transcripts provided by the Director of Nursing. When the surveyor requested documentation and policies regarding staff training, the facility was unable to provide a formal education policy but did submit a procedure outlining how staff are registered and assigned training modules through Relias. Despite this procedure, the lack of documentation for the CNA's resident rights training remained unresolved, indicating a lapse in the facility's process for ensuring and verifying completion of mandatory annual training for all staff. This deficiency potentially affected all 108 residents in the facility.

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