Failure to Ensure Required In-Service Training for Agency CNAs
Penalty
Summary
The facility failed to ensure that all Certified Nurse Aides (CNAs), including those provided by a temporary staffing agency, received the required 12 hours of in-service training, including dementia care and abuse prevention. Review of the Client Service Agreement between the facility and the temporary agency showed that the facility acknowledged agency CNAs as independent contractors and agreed that the agency was not their employer and was not responsible for their performance or non-performance. The agreement also documented that the agency had no responsibility for, control over, or involvement in the scope, nature, quality, character, timing, or location of the work performed by these CNAs. During the survey, the Administrator stated she did not have any documentation of trainings completed by the agency staff and confirmed she would not be able to provide any such documentation, noting that approximately 50% of the CNA staff were from the temporary agency. Interviews with residents further described concerns related to the care provided by agency CNAs. One resident stated that agency staff were "horrible" and did not seem to know what was going on. Another resident reported that agency staff did not care and had no idea what they were doing. A third resident stated that agency staff did not know anything about the residents and always did the bare minimum. These resident statements, combined with the lack of training documentation and the facility’s reliance on agency CNAs for about half of its CNA staffing, formed the basis of the deficiency related to failure to ensure required in-service training for all CNAs.
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