The information below comes from the statement of deficiencies compiled by health inspectors and provided to AHCJ by the Centers for Medicare and Medicaid Services. It does not include the steps the hospital plans to take to fix the problem, known as a plan of correction. For that information, you should contact the hospital, your state health department or CMS. Accessing the document may require you to file a Freedom of Information Request. Information on doing so is available here.

ST MICHAEL'S HOSPITAL - CAH 410 W 16TH AVE TYNDALL, SD 57066 March 14, 2018
VIOLATION: PROVISION OF SERVICES Tag No: C1004
Based on interview, personnel file review, contract file review, and policy review, the provider failed to ensure:
*A comprehensive orientation program was developed and implemented to orientate two of two sampled contracted personnel (B and C) to the emergency department (ED) hospital procedures for emergency care.
*Verification for two of two sampled contracted personnel (B and C) had documentation of their skills verification prior to conducting patient care without direct supervision.
Findings include:

1. Review of contracted personnel B and C's contract file revealed no documentation of orientation to the facility's ED. There was no verification their skills had been evaluated after they were hired to provide patient care in the ED.

Review of the personnel files of B and C revealed no documented orientation training or skills verification after their employment at the facility.

Refer to C274, finding 1.
VIOLATION: PATIENT CARE POLICIES Tag No: C1012
Based on interview, personnel file review, contract file review, and policy review, the provider failed to ensure:
*A comprehensive orientation program was developed and implemented to orientate two of two sampled contracted personnel (B and C) to the emergency department (ED) hospital procedures for emergency care.
*Verification for two of two sampled contracted personnel (B and C) had documentation of their skills verification prior to conducting patient care without direct supervision.
Findings include:

1. Review of employee B and C's contract personnel files revealed no documentation of being oriented to the facility's ED. There was no documentation their skills had been evaluated after they were hired to provide patient care in the ED.

Review of the personnel files for B and C revealed no documented orientation training or skills verification after their employment at the facility.

Interview on 3/12/18 at 11:01 a.m. with contract nurse B revealed:
*Her orientation consisted of working a twelve hour shift with a nurse.
*Her second shift consisted of working a twelve hour shift alongside another nurse.

Interview on 12/12/18 at 11:25 a.m. with the director of patient services confirmed:
*The facility had no formal orientation program for contracted personnel to perform duties and responsibilities in the ED.
*The director of patient services confirmed contracted personnel orientation was not documented.
*She relied on the staffing agency to verify competency.

Review of the provider's 3/16/10 Facility Staffing Agreement with the staffing agency revealed it was the facility's responsibility for the nurse's orientation.

Review of the provider's 1/15/18 Emergency Department policy for emergency services stated orientation was completed as part of the general orientation process.