QA Investigation Results

Pennsylvania Department of Health
ALL IN YOUR HOME, HOME CARE, LLC.
Health Inspection Results
ALL IN YOUR HOME, HOME CARE, LLC.
Health Inspection Results For:


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Initial Comments:

Based on the findings of an onsite unannounced state relicensure survey completed 6/05/2018, All in Your Home, Home Care, LLC 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 state relicensure survey completed 6/05/2018, All In Your Home, Home Care, LLC was found not to be in compliance with the following requirement(s) 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:




611.51(b) LICENSURE
Direct Care Worker Files

Name - Component - 00
Files for direct care workers employed or rostered shall include documentation of the date of the face-to-face interview with the individual and of references obtained. Direct Care Worker files also shall include other information as required by 611.52, 611.53, if applicable, 611.54, 611.55 and 611.56 (relating to criminal background checks, child abuse clearance, provisional hiring, competency requirements; and health evaluations).

Observations:

Based on review of direct care worker (DCW) personnel files (PF), and staff (EMP) interviews, the agency failed to ensure seven (7) of ten (10) DCW personnel files included documentation to show information as required under 611.52 to include Federal criminal history record and Proof of residency (PF1, PF3, PF5, PF6, PF8 - PF10).

Findings included:

A review of DCW personnel files was conducted on 6/05/2018 between 10:00 a.m. and 12:00 p.m.

Review of PF1 revealed no documentation to show the required Federal criminal history record was initiated or completed. PF1 was hired on 2/21/2017 and contained a Connecticut Driver's license issued on 10/29/2013 with an expiration date of 06/29/2018. PF contained no other documentation to show residency requirement was met.

PF3 was hired on 8/12/2016 and contained a PA Driver's license but the license was issued on 5/12/2016; not 2 years preceeding the date of hire. PF contained no other documentation to show requirement was met.

PF5 was hired on 6/12/2017 and contained a PA Driver's license but the license was issued on 12/08/2016; not 2 years preceeding the date of hire. PF contained no other documentation to show requirement was met.

PF6 was hired on 9/27/2017 and contained a PA Driver's license but the license was issued on 5/12/2016; not 2 years preceeding the date of hire. PF contained no other documentation to show requirement was met.

PF8 was hired on 11/02/2017 and contained a PA Driver's license but the license was issued on 2/23/2017; not 2 years preceeding the date of hire. PF contained no other documentation to show requirement was met.

PF9 was hired on 2/12/2017 and contained a PA Driver's license but the license was issued on 11/04/2015; not 2 years preceeding the date of hire. PF contained no other documentation to show requirement was met.

PF10 was hired on 12/08/2017 and contained a PA Driver's license but the license was issued on 6/22/2016; not 2 years preceeding the date of hire. PF contained no other documentation to show requirement was met.

Interview with EMP1, EMP2 & EMP3 on 6/5/2018 at approximately 3:00 p.m. confirmed findings.







Plan of Correction:

Owner reached out to the direct care workers to notify them that we need to have proof of them being a PA resident 2 years prior to the hire date. The direct care workers are able to bring an old drivers license, old utility bill, or a tax return and if they can't provide those then they will have to go get FBI finger printing. All proof and results will be maintained in the direct care workers file. For future we will make sure that they bring proof of 2 year residency in with them before the interview process and we will make sure it is copied and put in the direct care workers folder. We also added to our check list that is placed on front of each direct care workers folder (proof of 2 year residency) that all direct care wrokers must have before getting hired and entering homes. Owner or receptionist will make sure that the proper documentation is in their folder prior to them getting hired and entering homes.


611.55(e) LICENSURE
Competency Requirements

Name - Component - 00
The competency review must occur at least once per year after initial competency is established, and more frequently when discipline or other sanction, including, for example, a verbal warning or suspension, is imposed because of a quality of care infraction.

Observations:

Based on review of direct care worker (DCW) personnel files (PF), and staff interview, the agency failed to ensure four (4) of four (4) DCW personnel files, employed greater than a year contained an annual competency review (PF1 - PF3 & PF7).

Findings included:

A review of DCW personnel files was conducted on 6/05/2018 between 10:00 a.m. and 12:00 p.m.

PF1 was hired 2/21/2017 and contained no annual competency review (due 2/21/2018).

PF2 was hired 4/12/2017 and contained no annual competency review (due 4/12/2018).

PF3 was hired 8/12/2016 and contained no annual competency review (due 8/12/2017).

PF7 was hired 3/01/2017 and contained no annual competency review (due 3/01/2018).

Interview with EMP1, EMP2 & EMP3 on 6/05/2018 at approximately 3:00 p.m. confirmed findings.







Plan of Correction:

Owner/receptionist has reached out to the direct care workers to inform them that the PEAK testing that they were doing monthly didn't meet the criteria for the annual testing. The owner is having the direct care workers that have been here a year, go back and redo all the videos that they did at the time of hire. Going forward the owner/receptionist will notify the direct care worker that their annual competency is due. The receptionist/owner will know this by reviewing the direct care workers file that contains our check list once a month. Once the competency videos are completed they will be documented by the office staff printing out the certificate at the end of each video and placing them in the direct care workers file.
Required Video/ content matter are as followed;
Alzheimer's and Dementia Care
Activities to Keep your Consumer Engaged
Bathing and Showering someone with Dementia
Caring for an Agressive Person
The effects of Dementia on the Brain
How attitudes and the Environment Affect Agitation and Agression
Identifying and Assessing Aggression
Providing Care for Someone with Dementia
Understanding Dementia and Alzheimer's Disease
Understanding the Physical Causes of Agitation and Agression
Seniors and Aging
Assisting Stroke Patients
Caring for Consumers with Diabetes
Caring for Individuals with ALS
Dental and Oral Care
Effects of Aging on Emotions and the
Five Senses.
Elder Abuse and Neglect
Physical Changes of Aging
Preventing Fraud and Financial Abuse
of Seniors.
Proper Skin Care and Bathing
Infection Control
How to prevent pressure ulcers
How to protect against infection
Proper hand washing
recognizing common infection
Safety
Assistive Devices to help seniors and
people with disabilities
back anatomy and body mechanics
caregivers first aid
being safe while bringing care home
caring for obese, paralyzed or other
immobile consumers.
handling emergencies
incident reporting
recognizing signs of heat stroke, heat exhaustion and hypothermia.
tools to help lift and transfer consumers safely
transferring people, the right way
Medication and Pain
The aides role in palliative care and pain management
Detecting and understanding levels of pain
A pill's journey: How medications work
Idependence and Confidentiality
Caring for LGBT consumers
Consumer choice and independent living philosphy
Understanding activities of daily living
Understanding HIPPA and Confidentially
Understanding instrumental activities of daily living
End of Life Care
Understanding Hospice care
Miscellaneous
Assisting people with behavioral health issues
bed bug action plan for homecare
building relationships
caring for the blind and visually impaired
caring for the hearing impaired and deaf
depression: recognizing the signs and symptoms
ethical behaviors- What's right and wrong
Family resources
Health coaching: helping people manage their chronic conditions
importance of nutrition and diet for good health
Maintaining boundaries with a consumer
professionalism
understanding family dynamics
understanding Pennsylvania's Home care agency and Registry licensure.





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 review of the Centers for Disease Control and Prevention guidelines (CDC), direct care worker personnel files (PF), and staff (EMP) interview, the agency failed to ensure screenings for mycobacterium tuberculosis (TB) were conducted in accordance with CDC guidelines for two (2) of ten (10) active direct care worker personnel files reviewed ( PF6 & PF7).

Findings included:

According to the "Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in Health-Care Settings, 2005," "Baseline testing for M. Tuberculosis infection is recommended for all newly hired HCWs [health care workers] ... If TST [tuberculin skin testing] is used for baseline testing, two-step testing is recommended for HCWs 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. If a newly employed HCW has had a documented negative TST result within the previous 12 months, a single TST can be administered in the new setting ... This additional TST represents the second stage of the two-step testing."

A review of personnel files was conducted on 6/05/2018 between 10:00 a.m. and 12:00 p.m.

PF6 was hired on 9/27/2017. PF6 contained a negative TST result dated 6/14/2017 but did not contain documentation that the second-step was initiated or completed.

PF7 was hired on 3/01/2017. PF7 contained a negative TST result dated 3/03/2017 but did not contain documentation that the second-step was initiated or completed.

Interview with EMP1, EMP2 & EMP3 on 6/05/2018 at approximately 3:00 p.m. confirmed findings.







Plan of Correction:

The direct care worker will obtain a 1 step Tb test with a negative result prior to consumer contact. The direct care worker will then get the second step TB test 1-3 weeks after the read date of the first TB. Then that will complete the 2 step TB test. There after the owner would like her direct care workers to obtain a yearly TB test. The receptionist will keep track of the TB due dates by reviewing direct care worker folders monthly.


Initial Comments:

Based on the findings of an onsite unannounced state relicensure survey completed 6/05/2018, All In Your Home, Home Care, LLC was found to be in compliance with the requirements of 35 P.S. 448.809 (b).




Plan of Correction: