Failure to Provide Orientation and Training for Temporary Nursing Staff
Penalty
Summary
The facility failed to ensure that temporary nurses and CNAs received proper orientation and training before independently caring for residents. Multiple agency staff members, including CNAs and an RN, reported that they did not receive an orientation or education prior to working with residents. One CNA stated it was her second day at the facility and she had not been given an orientation or education checklist. Another CNA described working an overnight shift alone and attempting to transfer a resident without a mechanical lift, as she was unaware of the resident's needs. The RN recalled only receiving a brief tour and not a complete orientation or signed checklist. These accounts were corroborated by interviews and observations conducted by surveyors. A resident with a history of dialysis and recent hospitalization expressed concern about the lack of knowledgeable staff, stating that she had to instruct a CNA on how to assist with her catheter and toileting needs. The facility's administration acknowledged that orientation checklists were generally kept on the DON's desk, but could not provide documentation for the specific staff in question. The facility had an agency staff orientation checklist outlining required topics, but there was no evidence that all temporary staff had completed or signed off on this orientation prior to providing care.