Use of Uncertified Nurse Aides Beyond Four Months Without Completed Training and Competency Evaluation
Penalty
Summary
The deficiency involves the facility’s failure to ensure that nurse aides who worked more than four months were trained, competent, and had completed a state-approved nurse aide training and competency evaluation program (NATCEP) or competency evaluation, as required by 42 CFR §483.150(a) and (b). Review of employee files showed that multiple nurse aides (NA-A, NA-C, NA-F, NA-G, NA-H, NA-J, and NA-L) were hired and worked full time for periods exceeding four months without being certified within the required timeframe. The facility’s own nurse aide job description required that nurse aides either have completed a state-approved training and competency evaluation program and hold a current state certificate, or be enrolled in an approved competency training program and perform only services for which they had demonstrated competence. Interviews with the involved nurse aides and the AIT confirmed that these staff members were not certified and had not completed all required components of the NATCEP. NA-A reported she had previously taken CNA classes and passed the written test but failed the skills test and never retook it. NA-C stated she had completed 40 hours of online CNA training and two in-person classes, but the facility stopped the CNA classes before she could complete certification. NA-F reported passing a written exam but failing the clinical exam and was waiting on additional training hours. NA-H stated she completed 60 hours of computer training but had not completed clinical hours due to lack of a site to complete that portion. The AIT acknowledged that none of the nurse aides were certified because they had not tested, and that a planned NATCEP at a sister facility had been cancelled. Despite these circumstances, the nurse aides continued to work full time beyond four months without the required certification or completed competency evaluation.
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