Failure to Ensure Staff Competency Documentation for Nursing and CNA Staff
Penalty
Summary
The facility failed to ensure that both a registry nurse (LVN) and a regular CNA assigned to two residents had the necessary competencies documented in their employee files. For the LVN, who was assigned to a resident with Type 2 Diabetes, chronic kidney disease, and obesity, there was no full skills checklist or performance evaluation in the employee file. The Director of Staff Development (DSD) and Director of Nursing (DON) could not confirm whether the required documentation existed or was completed, and the LVN himself was unaware of any abuse training or skills checklist being completed through the facility or the registry. The only documentation provided was a nephrostomy training checklist and a vague orientation verification, which was acknowledged by facility leadership as insufficient and not specific to the facility. For the CNA, who was assigned to a resident with hemiplegia, cerebral infarction, and urinary incontinence, the employee file also lacked a skills checklist. The DSD noted that the CNA had a history of sleeping on the job, but no documentation of competency was available in the file. The Assistant Director of Nursing (ADON) was unable to provide information on when or how often performance evaluations or skills checklists were completed, indicating a lack of oversight in ensuring staff competency. A review of the facility's policy indicated that the administrator is responsible for verifying that agency and contract staff have documentation of competencies and skills to care for the resident population. However, the facility did not have the required documentation for the LVN and CNA, resulting in a failure to ensure that staff had the appropriate competencies to care for residents as required by facility policy.