QA Investigation Results

Pennsylvania Department of Health
AT HOME SENIOR SERVICES
Health Inspection Results
AT HOME SENIOR SERVICES
Health Inspection Results For:


There are  8 surveys for this facility. Please select a date to view the survey results.

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Initial Comments:


Based on the findings of an onsite unannounced complaint/event survey completed 4/18/2019, At Home Senior Services was found to be in compliance with the requirements of PA Code, Title 28, Health and Safety, Part IV, Health Facilities, Subpart A, Chapter 51.




Plan of Correction:




Initial Comments:


Based on the findings of an onsite unannounced complaint/event investigation survey completed 4/18/2019, At Home Senior Services was found not to be in compliance with the following requirement of PA Code, Title 28, Health and Safety, Part IV, Health Facilities, Subpart H, Chapter 611, Home Care Agencies and Home Care Registries.






Plan of Correction:




611.56(a) LICENSURE
Health Screening

Name - Component - 00
The screening shall be conducted in accordance with CDC guidelines for preventing the transmission of mycobacterium tuberculosis in health care settings. The documentation must indicate the date of the screening which may not be more than 1 year prior to the individual's start date.

Observations:



Based on a review of personnel files (PF), Centers for Disease Control (CDC) Guidelines, and staff (EMP) interview, it was determined the agency failed to ensure direct care workers were screened for tuberculosis (TB) in accordance with CDC guidelines for one (1) of four (4) PF reviewed (PF4).

Findings Included:

A review on 4/9/2019 at approximately 12:30 PM of the "CDC Morbidity and Mortality Weekly Report, Recommendations and Reports, December 30, 2005/Vol.54/No. RR-17 Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in Health-Care Settings, 2005", revealed "...Baseline testing for M. Tuberculosis infection is recommended for all newly hired HCW's [health care workers]...If TST [tuberculin skin testing] is used for baseline testing, two-step testing is recommended for HCW's whose initial TST results are negative...If the first-step TST result is negative, the second-step TST should be administered 1-3 weeks after the first TST result was read...A second TST is not needed if the HCW has a documented TST result from any time during the previous 12 months, a single TST can be administered in the new setting. This additional TST represents the second stage of two-step testing..."

Review of PF's completed on 4/9/2019 at approximately 11:50 AM to 12:25 PM revealed the following:

PF4, date of hire (DOH) 9/26/20118 PF contained evidence of a TST with an administration date of 7/13/2018 and read date of 7/16/2018 with negative results. The PF failed to contain evidence of a second TST conducted. The surveyor requested any additional information pertaining to the employees TB testing. No additional information was provided by the agency.

An exit interview was conducted with the president and principal on 4/9/2019 at approximately 2:00 PM which confirmed the above finding.





Plan of Correction:

Plan : All new emplpyees will have a two step prior to working in a clients home. At home senior services will not complete orientation until after all documents are in the file with two step TB. The dates will be recorded in the portal and new employee will remain inactive until the final step in the TB is in the file with documentation from the doctor of compeletion of negative TB.
The Owner and CEO is responisible for this implementation at this time.
will be monitored after every new hire by the owner and CEO, of At home Senior Services.
all files will be monitored on a monthly review for updates to TB that will expire to maintain up to date TB with staff moving forward./ the reports are monitored by home track our computer software monitoring system,



At Home Senior Services new employes shall have the 2-step intradermal skin test before beginning employment unless there is documentation of a previous positive skin reaction. Test results shall be made available prior to assumption of job responsibilities. CDC guidelines shall be followed with regard to repeat periodic testing of all employes. If an employe's chest X-ray is compatible with active TB, the individual shall be excluded from the workplace until a diagnosis of active TB is ruled out or a diagnosis of active TB is established and a determination made that the individual is considered to be noninfectious. A statement from a physician stating the individual is noninfectious shall be required.


611.57(a) LICENSURE
Consumer Rights

Name - Component - 00
(a) The consumer of home care services provided by a home care agency or through a home care registry shall have the following rights: (1) To be involved in the service planning process and to receive services with reasonable accommodation of individual needs and preferences, except where the health and safety of the direct care worker is at risk. (2) To receive at least 10 calendar days advance written notice of the intent of the home care agency or home care registry to terminate services. Less than 10 days advance written notice may be provided in the event the consumer has failed to pay for services, despite notice, and the consumer is more than 14 days in arrears, or if the health and welfare of the direct care worker is at risk.

Observations:



Based on a review of the agency consumer records (CR) and staff (EMP) interview, the agency failed to involve the consumer in the service planning process and to receive services with reasonable accommodation of individual needs and preferences for two (2) of four (4) CR's reviewed (CR3 and CR4), the agency failed to provide at least 10 calendar days advance written notice of the intent of the home care agency or home care registry to terminate services for one (1) of one (1) CR that services were terminated (CR4).

Findings included:

A review of the consumer packet on 4/9/2019 at approximately 10:00 AM revealed, document "Consumer Protection, Please sign that you have received the following forms from (agency) before the start of care: Consumer Bill of Rights, List of services that will be provided...Day(s) and Hours needed...Termination of Services...Emergency Backup Plan, How to report an incident."

A review of CR3 on 4/9/2019 at approximately PM revealed start of services 11/16/2018 revealed, the hours when services would be provided could not be verified, the schedule on the consumer service agreement, conclusion summary section was six days week with Wednesdays crossed out, the document was completed on 11/15/20218. The time period from 2/4/2019 to 3/29/2019 was reviewed to confirm if services were provided per service agreement. Per review of the time sheets, the surveyor was unable to verify services were provided per service agreement due to services being provided on Wednesdays.

A review of CR4 on 4/9/2019 at approximately 2:35 PM revealed start of services 2/12/2019. The hours when services would be provided per the consumer service agreement, conclusion summary section were Monday, Tuesday and Thursday from 9:30 AM to 11:30 AM. Services that were provided did not match the agency consumer schedule report from 4/9/2019 at 1:25 PM. The agency indicated that staffing was not available to continue services after 3/5/2019. A 10 day termination notice/letter was not located in CR4. The surveyor requested any additional termination documentation from (EMP1). No additional documentation was provided.

An exit interview was conducted with the president and principal on 4/9/2019 at approximately 2:00 PM which confirmed the above finding.









Plan of Correction:

The CEO and Owners and RN who assists with assessments will be responsible for implanting the 10 day termination and updating all files with the new policy-

At home senior services will provide a 10 day advance written notice to the client when services will be terminated.

clients will be made aware of the policy in the consumer package when the case is open to start care.

Client states to At home senior services what services they need- an assessment from is completed with the client and Nurse from At Home Senior Services to meet all the needs of the client. At home senior services includes all clients in the planning process for care and meets needs of days and times per the consumers request. the assessment shows documentation to the needs of clients and who will preform the care
times and days. The client always has the right to refuse care at any time.

this is overseen and implemented by owner and the RN At Home senior services
also all is recorded in home trak the computer system we use which is emilaed to client as well of schedule updates and prior to starting care is confirmed by client to Athome Senior services.


At Home Senior Services has updated all consumer records as well as notified consumers new as well on in service planning process and to receive services with reasonable accommodation of individual needs and preferences AT Home senior services will provide at least 10 calendar days advance written notice of services being terminated.