HospitalInspections.org

Based on interview and record review, the facility failed to ensure all staff hired through a travel staffing agency were provided training and education on abuse prohibition for one employee, staff member N, prior to providing patient care; and the facility failed to complete criminal background checks for employees C and Q, prior to the employees providing patient care. These deficient practices had the potential to affect all patients who were provided care at the facility. Findings include:

1. Abuse Training for Traveling Staff

During an interview on 12/11/18 at 11:40 a.m., staff member A stated staff employed by the facility through a travel staffing agency did not always get abuse training by the facility prior to providing patient care. She stated they expected the providing travel agency to ensure their staff had abuse prevention training.

During an interview on 12/11/18 at 12:03 p.m., staff member B stated they relied on the travel agencies to provide training on abuse prevention to their travel nurses and aides. She stated the facility did not always provide the newly contracted staff from travel agencies to complete abuse training before they worked the floor and provided patient care.

A review of staff member N's personnel file from the employing travel agency, showed the staff member was not provided abuse prohibition training by the travel agency.

A review of the worked scheduled for 10/1/18 to 12/11/18, showed staff member N worked the following dates prior to being provided abuse prevention training: 10/2/18, 10/3/18, 10/5/18, 10/6/18, 10/9/18, 10/10/18, 10/11/18, 10/13/18, 10/15/18, 10/16/18, 10/17/18, 10/20/18, 10/21/18, 10/23/18, 10/24/18, 10/27/18, 10/28/18, 10/29/18, 10/30/18, 10/31/18, 11/28/18, 12/2/18, 12/3/18, 12/4/18, 12/5/18, and 12/9/18.

During an interview on 12/11/18 at 4:20 p.m., NF3 stated they did not provide their employees with training or education on abuse prohibition. She stated they expected the facilities to take responsibility for training the staff they employ, on abuse prohibition, prior to the travel staff providing patient care at each facility.

During an interview on 12/11/18 at 4:50 p.m., staff member N stated he did not receive abuse prevention training from the travel company he was employed through. He stated he was not provided abuse training from the facility prior to working on the floor. He stated he had worked through the travel agency for the facility for 15 weeks prior to receiving any abuse training from the facility.

During an interview on 12/13/18 at 9:45 a.m., staff member B stated staff member N will be required to have abuse prohibition training prior to working his next shift.

A review of the facility's policy and procedure, titled Abuse Prevention and reporting, showed, "2. Training b) Social Services designee will provide abuse prevention and reporting training to new hires at orientation. New hires will have 30 days from hire date to complete 'Preventing, Recognizing, and Reporting Abuse' and "Resident Rights Inservice' on the online Relias Learning training system. If a new employee does not complete the modules within 30 days, the Administrative Assistant will notify the employee's Department Manager and the Administrator and the new employee will not be permitted to work until the modules are completed. The Social Services designee will give new employees the 'Mandatory Reporting for MT Nursing Facilities' brochure (Appendix A)... ."

2. Complete Background Checks

a. Review of the personnel file for staff member C showed the staff member was hired on 10/11/18. Review of the employee's background check showed the staff member's background check was not completed until 10/25/18 and was not adjudicated until 10/30/18. Review of a second background check conducted through the OIG, showed the background check was conducted on 10/22/18.

Review the facility's worked schedule from 10/1/18 to 10/31/18, showed staff member C worked the followings dates prior to the completion of the background check: 10/3/18, 10/4/18, 10/5/18, 10/11/18, 10/12/18, 10/13/18, 10/14/18, 10/17/18, 10/18/18, 10/21/18, 10/22/18, and 10/23/18.

During an interview on 12/11/18 at 11:40 a.m., staff member A stated background checks were completed on all staff who were hired by the facility. The staff member stated they wait until they hire the employee before running the background checks. She stated they sometimes did not have the background checks back before the employee started working the floor. She stated, "they might work a day or two before the background check was completed."

During an interview on 12/11/18 at 12:03 p.m., staff member B stated a background check was completed on all staff when they were hired. She stated this may not be completed before they start work at the facility.

During an interview on 12/11/18 at 1:00 p.m., staff member K stated a background check was completed on all staff. She stated they were advised not to conduct a background check until the employee was hired. She stated there were times the background checks were not back before the employee started working the floor.

b. Review of the personnel file for staff member Q showed the staff member was hired on 10/1/18. Review of the employee's background check showed one background check was completed for the staff member on 10/9/18 through OIG. There were no further background checks completed for staff member Q.

Review the facility's worked schedule from 10/1/18 to 10/31/18, showed staff member Q worked the followings dates prior to the completion of the background checks: 10/1/18 and 10/2/18.

During an interview on 12/11/18 at 11:40 a.m., staff member A stated a background check was not completed for staff member Q.

During an interview on 12/11/18 at 1:00 p.m., staff member K stated a background check was not completed for staff member Q.

Review of the facility's policy and procedure, titled Abuse Prevention and Reporting, showed, "... [Facility] will make inquiry of licensing authorities, including, but not limited to, the State nurse aide registry and will check references listed on applicant's application and use an agency to conduct criminal background checks. 1. Screening ... c) Payroll clerk will order criminal background check of new hires through current contracted agency."