cms_WV: 5665
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| rowid | facility_name | facility_id | address | city | state | zip | inspection_date | deficiency_tag | scope_severity | complaint | standard | eventid | inspection_text | filedate |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 5665 | PINE VIEW NURSING AND REHABILITATION CENTER | 515184 | 400 MCKINLEY AVENUE | HARRISVILLE | WV | 26362 | 2015-01-21 | 225 | F | 0 | 1 | XRGM11 | Based on employee personnel file review, review of Chapter 514.4.1 of the Medicaid manual and certification memorandum from the Bureau for Medical Services (BMS) regarding the requirements for criminal background checks to meet the requirements of the Affordable Care Act, staff interview, and review of facility policy, the facility failed to ensure criminal background investigations were completed for all employees prior to hire and every three (3) years thereafter throughout the remainder of employment. Eight (8) of fifteen (15) employees reviewed were found to not have required criminal background checks. The facility failed to complete criminal background investigations for two (2) employees (#10 and #42) at the time of hire. The facility also failed to incorporate in its policy a requirement for criminal background checks every three (3) years throughout the remainder of an individual's employment as required by BMS to meet the requirements of the Affordable Care Act. Six (6) employees (#46, #62, #68, #26, #69 and #13) who had worked in the facility for more than three (3) years, were found to not have had a criminal background check repeated by (MONTH) 1, 2014 as directed by BMS. This practice had the potential to affect all residents. Employee identifiers: #46, #62, #10, #42, #68, #26, #69, and #13. Findings include: a) On 01/20/15 at 11:00 a.m., a review of personnel files for new and tenured employees with Bookkeeper #20, identified the following: 1. Nurse Aide (NA) #46 A review of the personnel file for Nurse Aide (NA) #46, hired on 12/06/09, revealed a background check dated 11/14/10. The 11/14/10 background check was not timely, and no repeat background check had been conducted by (MONTH) 1, 2014 as required by BMS to meet the requirements of the ACA. 2. Activities Director #62 Review of the personnel file for Activities Director #62, hired 01/27/97, revealed no evidence of a statewide criminal background check completed since her date of hire. 3. Housekeeper #10 A review of the personnel file of Housekeeper #10, hired by the facility on 12/29/14, found no evidence of a statewide criminal background check completed at the time of hire. 4. Housekeeper #42 A review of the personnel file for Housekeeper #42, hired 10/29/14, found no evidence of a statewide criminal background check completed at the time of hire. b) On 01/21/15 at 8:20 a.m., review of additional personnel files with Bookkeeper #20 identified the following: 1. Licensed Practical Nurse (LPN) #68 Review of the personnel file of LPN #68, revealed she was hired 08/17/11. The date of her last background check was 09/24/11. The employee file lacked any evidence of a current statewide criminal background check. 2. NA #26 A review of NA #26's personnel file revealed she was hired 12/01/09. The file contained an initial background check dated 01/13/10. There was no evidence of an up to date statewide criminal background check. 3. Registered Nurse (RN) #69 Registered Nurse (RN) #69's record indicated her date of hire was 01/27/11 and her initial background check was 01/18/11. Review of her personnel file found no evidence of a current statewide criminal background check. 4. NA #13 A review of the personnel file for NA #13, hired 05/17/10, found no evidence of an up to date statewide criminal background check since the initial background check dated 06/08/10. c) In interviews with Bookkeeper #20 on 01/20/15 at 2:00 p.m., and again on 01/21/15 at 8:20 a.m., she confirmed the statewide criminal background investigations were not up to date for all of the facility's employees. She agreed the facility was not in compliance with the required state, federal, and Centers for Medicare and Medicaid Services (CMS) regulations. d) On 01/21/15 at 10:30 a.m., review of a copy of the facility's current policy titled Resident Abuse (Prohibition) provided by Bookkeeper #20, found Segment 3 under the section titled Implementation states: A statewide background check will be conducted for all potential new employees through the state police department or other capable private entity. A background check will also be completed in any other state the applicant is known to have lived in or held employment. The policy was silent in regards to the current requirements of the Affordable Care Act and completing criminal background investigations on current employees every three (3) years thereafter throughout the remainder of their employment. e) The Bureau for Medical Services Manual (BMS) includes: 5.14.4.1 Employment Restrictions. Criminal Investigation Background check (CIB) results which may place a member at risk of personal health and safety or have evidence of a history of Medicaid fraud or abuse must be considered by the nursing facility before placing an individual in a position to provide services to the member. At a minimum, a finger-print based State level criminal investigation background check must be conducted initially by the employer prior to hire and every three years thereafter throughout the remainder of the employment. If the prospective employee has lived out of the state within the last five (5) years, the agency must also conduct a federal background check utilizing fingerprints through the national crime information database (NCID). A policy clarification memorandum (memo) was issued to all Medicaid participating facilities on 02/15/13. The memo included .at a minimum, a fingerprint-based state level criminal investigation background check must be conducted initially by the employer prior to hire and every three (3) years thereafter throughout the employment. This policy pertains to new hires and current employees. Due to the magnitude of current employees in nursing facilities throughout the State of West Virginia, the Bureau for Medical Services will allow nursing facilities until (MONTH) 1, 2014, to have all current employees up to date with criminal background checks .For any new hires in the nursing facility, the policy is effective for those individuals as of (MONTH) 1, 2013. | 2018-09-01 |