Failure to Assess and Document Nursing Staff Competencies
Penalty
Summary
The facility failed to develop and implement a system to evaluate and document staff competencies in essential nursing skills and techniques for all reviewed staff, including RNs and CNAs. There was no nursing competency policy available, and staff files lacked documentation of completed competency assessments. For example, a registered nurse administered a toxic cancer therapy medication and performed stoma suctioning for a resident with complex medical needs without having received specific training or instructions for these procedures. The nurse was unaware of the differences between oral and stoma suctioning techniques and had not received documented training on handling toxic cancer treatments. Multiple CNAs and nurses had no documented evidence of competency assessments or training in key care areas, such as safe resident transfers. Staff development personnel reported that orientation checklists were not collected, skills workshops for new hires were not yet offered, and the last documented skills workshop was held over a year prior, with no individual competency records available. The last completed staff competency checklists dated back to February 2023. Leadership staff confirmed that competency assessments were expected on hire and annually, but could not provide documentation to support that these assessments had occurred.