Student Nurse Aides Used Beyond 4-Month Limit Without CNA Certification
Penalty
Summary
The deficiency involves the facility’s use of student nurse aides (SNAs) as nurse aides for more than four months without ensuring they had completed a required training and competency evaluation program or obtained CNA certification. Record review of SNA A’s employee file showed a hire date with no evidence of current nurse aide certification; an employability status check showed SNA A previously held a CNA certification that had expired. Record review of SNA B’s and SNA C’s employee files also showed hire dates with no evidence of CNA certification, and employability status checks indicated they had no CNA certification. Despite this, these individuals were used to provide direct resident care beyond the four‑month limit allowed for student nurse aides. During interviews, the RNC stated her expectation was that newly hired NAs would be enrolled in classes within 30 days and be certifiable at 60 days, and acknowledged there was no facility policy on NAs other than following NATCEP requirements. She stated SNAs should have been certified as CNAs no more than four months after hire and attributed the failure to the previous DON from a sister facility who had been responsible for monitoring SNA education and certification time frames. The ADMN similarly stated SNAs should have been certified within four months of hire, confirmed that the sister facility’s DON had not kept up with monitoring and tracking certification, and acknowledged that these SNAs had continued performing direct care with residents after the four‑month period. The ADMN stated the DON had been responsible for monitoring nurse aides and that there was potential harm for residents if staff were not properly trained to recognize out‑of‑range signs and symptoms. Facility documentation from the NATCEP Program Specialist and the facility’s own SNA job description confirmed that individuals could not be used as nurse aides for more than four months without completing training and testing, and that the SNA role was limited to 120 days in which certification must be obtained.
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