Over the next 12 months I am going to start a monthly survey spotlight. I will be discussing survey issues from experience, observation and current trends. I would love for people to share in these and make them a discussion on how to improve our survey outcomes across Ohio. I am tired of all of the negative press regarding nursing homes. I am seeing a huge jump in jeopardy level deficiencies and feel that this is one way to combat this. Please make comments and share your ideas and experiences.
Employee Records
The first area I am going to address is one that I have been seeing cited repeatedly in facilities and is very easy to correct. Inaccurate documentation in this are can be spread across several deficiencies including F225 and F226 abuse, F441 infection control and F497 employee records. It seems like we can all recite what is required but for some reason it just does not happen because of:
1.What I am seeing as the greatest cause of in accurate employee records is related to manager turnover and division of duties.
2. Employee records not maintained in the same area for example maintained in specific departments, managers files maintained in another location, contract employee files not maintained with other employee files.
3. Lack of training in preparing and maintaining employee files.
4. Access to paper work required for files.
Here is a short list of what the state focuses on during a survey in employee records
1. For new hires they focus on BCI log, references, proof of licensure/certification, orientation, Hepatitis B vaccine acceptance or refusal and TB
2. For State Tested Nurse Aides that have been employed over 1 year they look at all of the above and in addition to that they look at 90 days and annual evaluation, 12 hours of in-servicing for each, annual STNA specific competencies and annual TB
3. Nurses include an annual license verification and specific nurse competencies
Here are some suggestions for maintaining control of this area
1. Choose the gate keeper carefully. They must be trustworthy and very organized. Facilities come in all sizes and most do not have a human resources person so some other examples of appropriate positions are: receptionist, staff developer, scheduler or central supply person.
2. Once this person is chosen they will need education including what is required in an employee file, how it is organized, the rules governing employee records.
3. A safe secure locked cabinet for employee records.
4. A good copy of all forms
5. Allowed the time to maintain the records.
6. A list of all requirements for the file to be signed off on during processing to ensure that all the components are there.
7. Each department should sign off on the employee before the file is filed away.
8. I also recommend that the administrator also sign off on the record as well.
9. Complete audits of employee files monthly.
