Ask the Nursing Expert about ... staff competencies

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Judi Kulus, MSN, MAT, RN, NHA, RAC-MT, DNS-CT, Curriculum Development Specialist for AADNS
Judi Kulus, MSN, MAT, RN, NHA, RAC-MT, DNS-CT, Curriculum Development Specialist for AADNS

Is it true that during new survey process, surveyors will ask staff nurses and nursing assistants about their competencies, with questions such as, "Do you receive periodic evaluations on your skills, knowledge, and abilities? If so, how often?" "In what areas have you been assessed?" "In what areas do you believe you need more assistance or training?"

Yes. These may be the new survey process' “million-dollar” questions. After Nov. 28, 2017, surveyors will use an interview process to evaluate whether staff are “competent” to care for the facility's unique population. The new LTC survey protocol, CMS-20062, Sufficient and Competent Staff, includes asking staff the above questions. 

If survey results include adverse care outcomes with high scope and severity, fines will accumulate fast. They will be compounded if staff cannot confidently demonstrate competency.

To prepare your team, first complete the required Facility-Wide Assessment (FWA) outlined in the State Operations Manual Appendix PP, §483.70(e), which requires you to gather information about your facility's specific resident population, including diagnoses, conditions and care needs. From this, create a checklist of competencies for nurses and nursing assistants to effectively care for your residents.

Next, cross-check the list with each nursing staff member's competencies, identifying gaps between the employee's training and the residents' care needs. Throughout this review process, encourage all nurses and nursing assistants to be fully involved in self-analysis. 

Finally, ask staff the same competency questions that surveyors will ask (from CMS-20062). This will prepare them to answer surveyors honestly and confidently, indicating good training and skills.