Failure to Provide Behavioral Health Training for Staff
Penalty
Summary
The facility failed to ensure that staff received behavioral health training as required, specifically in managing residents with maladaptive behaviors such as being disruptive, cursing, and spitting at staff. This deficiency was identified during the review of an incident involving a resident with diagnoses including bipolar disorder, post-traumatic stress disorder, and frontotemporal neurocognitive disorder. The resident, who had a history of making false statements and being easily frustrated with staff, was involved in an altercation where they took a piece of cake intended for another resident, ate it, and then spat it at a CNA after being confronted. The CNA involved in the incident attempted to retrieve the cake and placed her hand in front of the resident's mouth to prevent being spat on, which led to the resident alleging that the CNA hit them. The CNA later acknowledged that her response was inappropriate and that she should have walked away instead. The facility's documentation did not provide evidence that the CNA had received specific behavioral health or mental health training, nor was there documentation confirming completion of the required annual in-service training on these topics. The facility's assessment indicated that services were provided for residents with mental health and behavioral needs, and that training and competency checks were to be conducted upon hire, monthly, and annually, including dementia management and care of cognitively impaired residents. However, the lack of documented evidence of behavioral health training for the CNA contributed to the deficient practice, as staff were not adequately prepared to cope effectively with residents exhibiting challenging behaviors.