Failure to Ensure Staff Competency and Required Training for Resident Care
Penalty
Summary
The facility failed to ensure that nursing staff, specifically a certified nursing assistant (CNA) and a medication technician (MT), possessed the appropriate competencies and skills to assure resident safety and respond to resident needs. The CNA assessed vital signs for a resident experiencing a change of condition without documented proof of competency to collect vitals and without a comprehensive assessment being performed by a registered nurse (RN) or monitoring by a licensed practical nurse (LPN). According to facility policy and job descriptions, CNAs are required to report changes in resident condition to a nurse, and only nurses or trained med techs are permitted to take vital signs in certain situations. Interviews with staff and review of records confirmed that the CNA took vital signs during a change of condition, and there was no evidence of a licensed nurse assessment or documentation of the vital signs in the resident's medical record. Additionally, the MT responsible for blood draws did not have evidence of certification to perform blood draws as required by state regulations. The facility relied on the MT to perform all blood draws, as the contracted laboratory did not provide this service. When requested, the facility was unable to provide documentation of the MT's certification for blood draws, only that the MT had requested transcripts of a completed course. This lack of documentation meant the facility could not demonstrate that the MT was qualified to perform this task. Furthermore, the MT did not complete the required four hours of pharmacy-related in-service education for each of the past three calendar years, as mandated by state guidelines. Review of the MT's education records showed insufficient hours in 2022, 2023, and 2024, with no education provided in 2022 and less than the required hours in subsequent years. The MT did meet the requirement for hours worked, but the deficiency in required education and lack of certification documentation for blood draws affected the facility's ability to ensure safe and competent care for approximately 25 residents in the affected zones.