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dysfunction, first aid for accidents or illness, and basic skills required to meet the health needs

of the clients.

Guidance §483.460(c)(5)(iii)

Nursing staff must train and ensure direct support staff demonstrate competency in detecting

signs and symptoms of illness, injury, or change in the client’s health baseline (e.g.

responsiveness, fatigue, irritability, constipation, diarrhea, dehydration, confusion, unexplained

weight loss, changes in endurance and changes in respiratory function).

Staff is responsive to health care needs or injuries of clients and receives instruction and support

during temporary illness of clients.

If not, review staff training records to determine whether training was provided periodically to

the involved employee. Interview direct care staff to determine their level of understanding

regarding the signs and symptoms of illness that are to be reported to the medical staff. The

records of clients with recent hospitalizations verify that staff detected and reported relevant

symptoms promptly.

(d) Standard: Nursing staff