QA Investigation Results

Pennsylvania Department of Health
AT HOME SPECIAL CARE, LLC
Health Inspection Results
AT HOME SPECIAL CARE, LLC
Health Inspection Results For:

This is the only survey for this facility

Surveys don't appear on this website until at least 41 days have elapsed since the exit date of the survey.



Initial Comments:


Based on the findings of an onsite unannounced relicensure survey completed 9/17/2018, At Home Special 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 9/17/2018, Home Special Care LLC was found not to be in compliance with the following requirements 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(a) LICENSURE
Hiring or Rostering Prerequisites

Name - Component - 00
Prior to hiring or rostering a direct care worker, the home care agency or home care registry shall: (1) Conduct a face-to-face interview with the individual. (2) Obtain not less than two satisfactory references for the individual. A satisfactory reference is a positive, verifiable reference, either verbal or written, from a former employer or other person not related to the individual that affirms the ability of the individual to provide home care services. (3) Require the individual to submit a criminal history report, in accordance with the requirements of 611.52 (relating to criminal background checks), and a ChildLine verification, if applicable, in accordance with the requirements of 611.53 (relating to child abuse clearance).

Observations:


Based on review of agency documents, personnel files (PF), and staff interview, it was determined the agency failed to conduct a face to face interview with the applicant for two (2) of four (4) PF's or obtain verification of two (2) positive references for the applicant for three (3) of four (4) PF's reviewed (PF1, PF2, and PF4).

Findings include:

Review of agency documents on 9/17/2018 at approximately 10:38 AM revealed: "Caregiver Hiring Process POLICY...5) Perform Reference Audits (3 professional & 3 personal) 6) If references are positive, call the applicant...Conduct face to face interviews at this time...3 Part Interviewing Process: The potential caregiver will come in the first time to fill out application and skills inventory form. He/She will come in a second time to complete the home Health Competency Test and have a face to face interview. He/She will come in to office a third time to receive the handbook, copies of Caregiver information and have their picture taken for their badge."

A review of the PFs conducted on 12/27/2017 at approximately 1:10 PM to 3:00 PM revealed the following:

PF#1, date of hire (DOH) 7/6/2018. The PF did not contain evidence of a face to face interview having been completed, or evidence of two references having been verified as positive by the agency.

PF#2, DOH 2/1/2018: The PF did not contain evidence of two references having been verified as positive by the agency.

PF#4, DOH 8/1/2018, The PF did not contain evidence of a face to face interview having been completed, or evidence of two references having been verified as positive by the agency.

An exit interview was conducted with the director on 9/17/2018, at approximately 1:40 PM which confirmed the above findings.










Plan of Correction:

The agency owner has appointed the Staff Supervisor to monitor the continued implementation of the plan of correction:

PF#1: A face to face interview was conducted and two positive references have been verified and are in employee file.

PF#2: Two positive references have been verified and are in employee file.

PF#4 A face to face interview was conducted and two positive references have been verified and are in employee file.

Specific training has been provided to the Staff Supervisor concerning documentation on face to face interviews and positive references in compliance with 611.51 (a) (1) and (2)


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 a review of agency policy, personnel files (PF) and staff (EMP) interview, it was determined the agency failed to include documentation of the date of the face-to-face interview with the individual and/or documentation of two satisfactory reference obtained for one (1) of four (4) PF reviewed (PF3).

Findings:

Review of agency documents on 9/17/2018 at approximately 10:38 AM revealed: "Caregiver Hiring Process POLICY...5) Perform Reference Audits (3 professional & 3 personal) 6) If references are positive, call the applicant...Conduct face to face interviews at this time..."

Review of direct care worker PF3, date of hire (DOH) 3/24/2018, on 9/17/2018 at approximately 10:42 AM revealed, no documentation was available to confirm the date three (3) references were obtained.

An exit interview was conducted with the director on 9/17/2018, at approximately 1:40 PM which confirmed the above findings.









Plan of Correction:

The agency owner has appointed the Staff Supervisor on as the responsible party to monitor this plan of correction to be in compliance with 611.51 (b)

PF#3 on 9/28/18, employee file has documentation to confirm three positive references have been obtained.

Staff Supervisor was re-educated on all Hiring Process' to ensure compliance on employee file documentation.



611.52(a) LICENSURE
Criminal Background Checks

Name - Component - 00
The home care agency or home care registry shall require each applicant for employment or referral as a direct care worker to submit a criminal history report obtained at the time of application or within 1 year immediately preceding the date of application.

Observations:


Based on a review of personnel files (PF's), agency policy and staff (EMP) interview, the agency failed to ensure each applicant for employment as a direct care worker submitted a criminal history report obtained at the time of application or within 1 year immediately preceding the date of hire for three (3) of four (4) PF's reviewed (PF1, PF2 and PF4).

Findings include:

Review of agency policy on 9/17/2018 at approximately 10:38 AM revealed, "EMPLOYMENT REFERENCE, OIG RECORD & CRIMINAL HISTORY CHECK POLICY, (agency) will request an applicant to furnish proof of residency, through submission of anyone of the following documents: Driver's License or State-Issued identification...will maintain files for Direct Care Workers and members of the Office Staff which include copies of State Police criminal history records or Department of Aging letters of determination regarding Federal criminal history records. These files will be available for the Department of Health inspections...State Police Check: In addition, a criminal check is required. For applicants who have not lived or worked in the state of Pennsylvania for two (2) years, an FBI check is required. (agency) will provide the background check application that must be completed. The completed response for the criminal background check must be returned to the office during the second part of the interview process or within ninety (90) days of the employment application. Applicants who have lived or worked in Pennsylvania for the last two (2) years are required to submit to a criminal background check."

PF1, DOH 7/6/2018, was reviewed on 9/17/2018 at approximately 10:45 AM, no documentation of a completed criminal history report was available. There was no documentation to confirm that a criminal background check was completed as per agency policy.

PF2, DOH 2/1/2018, was reviewed on 9/17/2018 at approximately 10:50 AM, no documentation of a completed criminal history report was available. There was no documentation to confirm that a criminal background check was completed as per agency policy.

PF4, DOH 8/1/2018, was reviewed on 9/17/2018 at approximately 11:00 AM, no documentation of a completed criminal history report was available. There was no documentation to show that a criminal background check was completed as per agency policy.

An exit interview was conducted with the director on 9/17/2018, at approximately 1:40 PM which confirmed the above findings.








Plan of Correction:

Agency owner appointed the Staff Supervisor to use a software program to obtain criminal background checks. She/he will monitor the plan of correction to be in compliance with 611.52 (a)

PF#1, A Criminal History Report was completed and is in the employee file.

PF#2, A Criminal History Report was completed and is in the employee file.

PF#4, A Criminal History Report was completed and is in the employee file.

The Staff Supervisor was re-educated on 9/28/18 to ensure background requirement compliance.

A new policy is enforced as of 9/28/18 is as follows to ensure the background check is in each employee file and for continued compliance:

PERSONNEL FILE POLICY
________________________________________
PURPOSE: To ensure the Agency is in compliance with state requirements in the HHA/HHR hiring process and retention of documentation.
POLICY: It is the policy of At Home Special Care to make available to the employee, office staff and surveyors, the following contents which are to be in each employee file.
1. Driver's License
2. Copy of TB testing
3. Investigative Background check documentation
4. Competency Test scores or nursing license
5. Proof of car insurance
6. Proof of residence for the past 2 years
7. Three (3) positive professional audit verifications
8. Three (3) positive personal audit verifications
9. Dates of face to face interviews and signature of interviewing staff member.
10. Interview questions and answers
11. Signed consent forms
12. Orientation and training documentation
13. CPR and basic first aid certification if applicable
14. Employee badge (copy)
All employee files must be checked and updated by the Staff Supervisor on a monthly basis to ensure compliance.




611.52(d) LICENSURE
Proof of Residency

Name - Component - 00
The home care agency or home care registry may request an individual required to submit or obtain a criminal history record to furnish proof of residency through submission of any one of the following documents:
(1) Motor vehicle records, such as a valid driver ' s license or a State-issued identification.
(2) Housing records, such as mortgage records or rent receipts.
(3) Public utility records and receipts, such as electric bills.
(4) Local tax records.
(5) A completed and signed, Federal, State or local income tax return with the applicant ' s name and address preprinted on it.
(6) Employment records, including records of unemployment compensation

Observations:


Based on a review of policy, personnel files (PFs) and staff (EMP) interview, it was determined the agency failed to show proof of residency in this Commonwealth for the 2 years preceding the date of hire (DOH) for four (4) of four (4) PFs reviewed (PF1, PF2, PF3 and PF4).

Findings include:

Review of agency documents on 9/17/2018 at approximately 10:38 AM revealed, "EMPLOYMENT REFERENCE, OIG RECORD & CRIMINAL HISTORY CHECK POLICY, (agency) will request an applicant to furnish proof of residency, through submission of anyone of the following documents: Driver's License or State-Issued identification...State Police Check: In addition, a criminal check is required. For applicants who have not lived or worked in the state of Pennsylvania for two (2) years, an FBI check is required. (agency) will provide the background check application that must be completed. The completed response for the criminal background check must be returned to the office during the second part of the interview process or within ninety (90) days of the employment application. Applicants who have lived or worked in Pennsylvania for the last two (2) years are required to submit to a criminal background check. The completed response for the criminal background check must be returned to the office during the second part of the interview process or within thirty (30) days of the return of the employment application."

A review of PF #1 on 9/17/2018 at approximately 10:45 AM, date of hire (DOH) 7/6/2018 revealed: There was no documentation available in the PF to confirm the agency verified proof of residency in this Commonwealth for two (2) years immediately preceding the date of hire.

A review of PF #2 on 9/17/2018 at approximately 10:50 AM DOH 2/1/2018 revealed: There was no documentation in the PF to confirm agency verified proof of residency in this Commonwealth for two (2) years immediately preceding the date of hire.

A review of PF #3 on 9/17/2018 at approximately 10:55 AM, DOH 3/24/2018 revealed: There was a Pennsylvania driver's license with an issue date of 5/7/2016. There was no additional documentation in PF to confirm the agency verified proof of residency in this Commonwealth for two (2) years immediately preceding the date of hire.

A review of PF #4 on 9/17/2018 at approximately 11:00 AM, DOH 8/1/2018 revealed: There was a Pennsylvania driver's license with an issue date of 4/4/2016. There was no additional documentation in PF to confirm the agency verified proof of residency in this Commonwealth for two (2) years immediately preceding the date of hire.

An exit interview was conducted with the director on 9/17/2018, at approximately 1:40 PM which confirmed the above findings.













Plan of Correction:

The agency owner has appointed the Staff Supervisor to monitor this plan of correction in accordance with 611.52 (d)

PF#1 conducted background checks and provided 2016 and 2017 tax returns and pay stubs as a proof of residency for the past 2 years. The documentation is in the employee file.

PF#2 conducted background checks and provided electric bills from 2016 and 2017 as proof of residency for the past 2 years. The documentation is in the employee file.

PF#3 conducted background checks and provided employment pay stubs for 2016 and 2017 as proof of residency for the past 2 years. The documentation is in the employee file.

PF#4 conducted background checks and provided utility bills from 2016 and 2017 for the past 2 years as proof of residency. The documentation is in the employee file.

Re-education was given to the Staff Supervisor on 9/28/18 concerning the updated Hiring Process Policy and criminal background checks on all applicants.

Hiring Process Policy was updated on 8/28/18 to ensure all background checks are being done on the implemented software program, Clear Care.
Initial Interview
Hiring Process Policy:
*Conduct Criminal Background Check on Clear Care.
.
All employee files have been updated on 9/27/18




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 agency policy, Centers for Disease Control (CDC) Guidelines, personnel files (PF) 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 three (3) of four (4) PF's reviewed (PF1, PF2 and PF4).

Findings Included:

Review of agency policies on 9/17/2018 at approximately 10:26 AM revealed: "TB Policy: MYCOBACTERIUM TUBERCULOSIS EXPOSURE CONTROL PLAN...ADMINISTRATIVE RESPONSIBILITIES: Registry/Agency-wide management of the Tuberculosis (TB) Exposure Control Plan will be the responsibility of...Office Manager...ALL DIRECT CARE WORKERS WITH (agency) MUST PARTICIPATE IN AN ANNUAL PPD SCREENING, IN ADDITION TO THEIR INITIAL PPD TESTING... "

A review on 9/17/2018 at approximately 2:28 PM of "CDC MMWR 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 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, a single TST can be administered in the new setting...This additional TST represents the second stage of two-step testing..."

PF#1, was reviewed on 9/17/2018 at approximately 10:45 AM, DOH 7/6/2018, confirmed the first step TST test was read on 7/3/2018, the test was negative. There was no documented evidence of the second step TST being completed.

PF#2, was reviewed on 9/17/2018 at approximately 10:50 AM, DOH 2/1/2018, confirmed the first step TST test was read on 2/9/2018, the test was negative. There was no documented evidence of the second step TST being completed.

PF#4, was reviewed on 9/17/2018 at approximately 11:00 AM, DOH 8/1/2018, confirmed the first step TST test was read on 8/17/2018, the test was negative. There was no documented evidence of the second step TST being completed.


An exit interview was conducted with the director on 9/17/2018, at approximately 1:40 PM which confirmed the above findings.









Plan of Correction:

The agency owner appointed the Staff Supervisor to monitor the continued plan of correction to be in compliance with 611.56 (a)

PF#1, was sent to Health Force to obtain the 2-step TB test. Testing will be completed on 10/10/18.

PF#2, was sent to Health Force to obtain the 2-step TB test. Testing will be completed on 10/10/18.

PF#4, was sent to Health Force to obtain the 2-step TB test. Testing will be completed on 10/10/18.

A new policy has been enforced to ensure compliance with all future employees and to ensure remedies are sustained concerning TB screening and is as follows:
TB Policy:
MYCOBACTERIUM TUBERCULOSIS EXPOSURE CONTROL PLAN:
______________________________________
In view of the increasing incidence of Tuberculosis and the potential nosocomial transmission of this disease to clients and employees of this Company, At Home Special Care LLC has adopted the following policies and procedure as our Tuberculosis Exposure Control Plan. A 2-step TB screening will be obtained by Health Force of Altoona PA before an employee is permitted to be added to a schedule.

ADMINISTRATIVE RESONSIBILITIES:

Registry/Agency-wide management of the Tuberculosis (TB) Exposure Control Plan will be the responsibility of the Staff Supervisor. This written plan will be maintained as part of the Company's Infection Control Manual and will be distributed to all Branch offices of the Company. The plan will be updated as needed, and formally reviewed and approved by each offices' Director/Owner.

RESPIRATION PROTECTION:
Appropriate respiratory protection will be worn by all persons entering a home where there is a risk of contracting TB.
Respiratory protective equipment will be available at the Office in appropriate styles and sizes to meet the needs of DCW while performing duties that may potentially expose them to TB.

ALL DIRECT CARE WORKERS WITH AT HOME SPECIAL CARE MUST PARTICIPATE IN AN ANNUAL PPD SCREENING, IN ADDITION TO THEIR INITIAL 2-STEP PPD TESTING.

Signature of Direct Care Worker:___________________

Date: ___/___/______

Updated 9/28/2018

The Staff Supervisor has been re-educated concerning 2-step TB initial screening.




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 consumer records (CR) and staff 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 nine (9) of ten (10) CR's reviewed (CR1,CR2, CR3, CR4, CR5, CR6, CR7, CR9 and CR10).

Findings included:

Review of agency policies on 9/17/2018 at approximately 9:52 AM revealed, "Policies and Procedures 2016...CLIENT INTAKES: Give client a copy of our services and explain what the caregivers are permitted to do that are referred by us. All of our clients are to be involved in the planning process and asked to complete the care plan to meet their needs and wants...Leave client folder with all packet information and signatures..."

Review of agency policies on 9/17/2018 at approximately 9:52 AM revealed, "CLIENT SERVICE AGREEMENT...9. Clients have the right to be involved in the entire service planning process which will be done at the initial Client Intake by a Personal Care Plan Coordinator. All Clients will receive the services allowed by law for a non-medical home care registry/agency with reasonable accommodations..."

A review of CR1 on 9/17/2018 at approximately 12:26 PM, start of services 8/13/2018 revealed: No agency service agreement was available in the CR to confirm that the agency had met with consumer/consumer representative to discuss the individual service planning needs and preferences.

A review of CR2 on 9/17/2018 at approximately 12:30 PM start of services 2/19/2018 revealed: No agency service agreement was available in the CR to confirm that the agency had met with consumer/consumer representative to discuss the individual service planning needs and preferences.

A review of CR3 on 9/17/2018 at approximately 12:28 PM, start of services 9/20/2017 revealed: No agency service agreement was available in the CR to confirm that the agency had met with consumer/consumer representative to discuss the individual service planning needs and preferences.

A review of CR4 on 9/17/2018 at approximately 12:42 PM, start of services 12/19/2017 revealed: No agency service agreement was available in the CR to confirm that the agency had met with consumer/consumer representative to discuss the individual service planning needs and preferences.

A review of CR5 on 9/17/2018 at approximately 12:58 PM, start of services 7/19/2018 revealed: No agency service agreement was available in the CR to confirm that the agency had met with consumer/consumer representative to discuss the individual service planning needs and preferences.

A review of CR6 on 9/17/2018 at approximately 1:07 PM, start of services 10/19/2017 revealed: No agency service agreement was available in the CR to confirm that the agency had met with consumer/consumer representative to discuss the individual service planning needs and preferences.

A review of CR7 on 9/17/2018 at approximately 1:09 PM, start of services 8/1/2018 revealed: No agency service agreement was available in the CR to confirm that the agency had met with consumer/consumer representative to discuss the individual service planning needs and preferences.

A review of CR9 on 9/17/2018 at approximately 1:25 PM, start of services 2/8/2018 revealed: No agency service agreement was available in the CR to confirm that the agency had met with consumer/consumer representative to discuss the individual service planning needs and preferences.

A review of CR10 on 9/17/2018 at approximately 1:28 PM, start of services 1/17/2018 revealed: No agency service agreement was available in the CR to confirm that the agency had met with



An exit interview was conducted with the director on 9/17/2018, at approximately 1:40 PM which confirmed the above findings.






Plan of Correction:

The agency owner appointed the Personal Care Plan Coordinator to monitor the plan of corrections in accordance with 611.57(a)

CR#1, On 9/20/18, The Service Agreement document was scanned and placed in client file to confirm agency met with the client to discuss the service plan needs.

CR#2, The Service Agreement document was scanned and placed in client file to confirm agency met with the client to discuss the service plan needs.

CR#3, The Service Agreement document was scanned and placed in client file to confirm agency met with the client to discuss the service plan needs.


CR#4, The Service Agreement document was scanned and placed in the client file to confirm the agency met with the client to discuss the service plan needs.

CR#5, The Service Agreement document was scanned and placed in the client file to confirm the agency met with the client to discuss the service plan needs.

CR#6, The Service Agreement document was scanned and placed in the client file to confirm the agency met with the client to discuss the service plan needs.

CR#7, The Service Agreement document was scanned and placed in the client file to confirm the agency met with the client to discuss the service plan needs.

CR#9, The Service Agreement document was scanned and placed in the client file to confirm the agency met with the client to discuss the service plan needs.

CR#10, The Service Agreement document was scanned and placed in the client file to confirm the agency met with the client to discuss the service plan needs.
The Personal Care Plan Coordinator was re-educated on 9/28/18 and will ensure this corrective action is enforced to provide all vital information in client files.
A new policy was enforced and added to the Staff Policy Manual on 9/28/18 on what is to be included in each client file in the agency office and is as follows:


CLIENT FILE LIST POLICY
____________________________________
PURPOSE: To ensure that all client files are intact with all vital information and available at the time of any audits or surveys.
POLICY: The Personal Care Plan Coordinator is responsible for client intakes. Therefore, he/she is responsible for maintaining all vital information be added to the client files that are in the office.
CLIENT FILES MUST CONTAIN:
- Client Care Plan completed; signed by client and PCPC
- Client Service Agreement completed; signed by client and PCPC
- Notice of HIPPA and Privacy Practices completed; signed by client
- Authorization and Demographics on client for third party payors
- Monthly survey audits made by PCPC
- Copy of POA documentation if applicable
- Invoices and proof of payments
Client files must be complete and available at all times for auditing and surveyors.
Client files must be kept confidential and locked when office is closed.
Only office staff may have access to client files on a need to know basis.
Updated: 9/28/18

Re-education was delivered on 9/28/18, to the Personal Care Plan Coordinator to ensure continued policy compliance.


611.57(c) LICENSURE
Information to be Provided

Name - Component - 00
(c) Prior to the commencement of services, the home care agency or home care registry shall provide to the consumer, the consumer's legal representative or responsible family member an information packet containing the following information in a form that is easily read and understood: (1) A listing of the available home care services that will be provided to the consumer by the direct care worker and the identity of the direct care worker who will provide the services. (2) The hours when those services will be provided. (3) Fees and total costs for those services on an hourly or weekly basis. (4) Who to contact at the Department for information about licensure requirements for a home care agency or home care registry and for compliance information about a particular home care agency or home care registry. (5) The Department's complaint Hot Line (1-800-254-5164) and the telephone number of the Ombudsman Program located with the local Area Agency on Aging (AAA). (6) The hiring and competency requirements applicable to direct care workers employed by the home care agency or referred by the home care registry. (7) A disclosure, in a format to be published by the Department in the Pennsylvania Bulletin by February 10, 2010, addressing the employee or independent contractor status of the direct care worker providing services to the consumer, and the resultant respective tax and insurance obligations and other responsibilities of the consumer and the home care agency or home care registry.

Observations:


Based on a review of the consumer records (CR) and staff interview, the agency failed to provide required information in writing to the consumers/consumer representatives prior to the commencement of services for nine (9) of ten (10) CR's reviewed (CR1,CR2, CR3, CR4, CR5, CR6, CR7, CR9 and CR10).

Findings included:

A review of CR #1 on 9/17/2018 at approximately 12:26 PM revealed start of services 8/13/2018. No documentation was provided by the agency to confirm the consumer/consumer representative was provided an information packet containing the following:
1. The services to be provided and the identity of the direct care worker who would provide services.
2. The hours when services would be provided.
3. Who to contact at the Department of Health for information about regulations and/or home care agency/registry compliance.
4. The Department of Health's complaint hotline.
5. The local Area Agency on Aging's Ombudsman Program telephone number.
6. The hiring and competency requirements of direct care workers.
7. The consumer disclosure notice regarding employee or independent contractor status of direct care workers and the resultant tax and insurance obligations and other responsibilities.

A review of CR #2 on 9/17/2018 at approximately 12:30 PM revealed start of services 2/19/2018. No documentation was provided by the agency to confirm the consumer/consumer representative was provided an information packet containing the following:
1. The services to be provided and the identity of the direct care worker who would provide services.
2. The hours when services would be provided.
3. Who to contact at the Department of Health for information about regulations and/or home care agency/registry compliance.
4. The Department of Health's complaint hotline.
5. The local Area Agency on Aging's Ombudsman Program telephone number.
6. The hiring and competency requirements of direct care workers.
7. The consumer disclosure notice regarding employee or independent contractor status of direct care workers and the resultant tax and insurance obligations and other responsibilities.

A review of CR #3 on 9/17/2018 at approximately 12:38 PM revealed start of services 9/20/2017. No documentation was provided by the agency to confirm the consumer/consumer representative was provided an information packet containing the following:
1. The services to be provided and the identity of the direct care worker who would provide services.
2. The hours when services would be provided.
3. Who to contact at the Department of Health for information about regulations and/or home care agency/registry compliance.
4. The Department of Health's complaint hotline.
5. The local Area Agency on Aging's Ombudsman Program telephone number.
6. The hiring and competency requirements of direct care workers.
7. The consumer disclosure notice regarding employee or independent contractor status of direct care workers and the resultant tax and insurance obligations and other responsibilities.

A review of CR #4 on 9/17/2018 at approximately 12:42 PM revealed start of services 12/19/2017. No documentation was provided by the agency to confirm the consumer/consumer representative was provided an information packet containing the following:
1. The services to be provided and the identity of the direct care worker who would provide services.
2. The hours when services would be provided.
3. Who to contact at the Department of Health for information about regulations and/or home care agency/registry compliance.
4. The Department of Health's complaint hotline.
5. The local Area Agency on Aging's Ombudsman Program telephone number.
6. The hiring and competency requirements of direct care workers.
7. The consumer disclosure notice regarding employee or independent contractor status of direct care workers and the resultant tax and insurance obligations and other responsibilities.

A review of CR #5 on 9/17/2018 at approximately 12:58 PM revealed start of services 7/19/2018. No documentation was provided by the agency to confirm the consumer/consumer representative was provided an information packet containing the following:
1. The services to be provided and the identity of the direct care worker who would provide services.
2. The hours when services would be provided.
3. Who to contact at the Department of Health for information about regulations and/or home care agency/registry compliance.
4. The Department of Health's complaint hotline.
5. The local Area Agency on Aging's Ombudsman Program telephone number.
6. The hiring and competency requirements of direct care workers.
7. The consumer disclosure notice regarding employee or independent contractor status of direct care workers and the resultant tax and insurance obligations and other responsibilities.

A review of CR #6 on 9/17/2018 at approximately 1:07 PM revealed start of services 10/19/2017. No documentation was provided by the agency to confirm the consumer/consumer representative was provided an information packet containing the following:
1. The services to be provided and the identity of the direct care worker who would provide services.
2. The hours when services would be provided.
3. Who to contact at the Department of Health for information about regulations and/or home care agency/registry compliance.
4. The Department of Health's complaint hotline.
5. The local Area Agency on Aging's Ombudsman Program telephone number.
6. The hiring and competency requirements of direct care workers.
7. The consumer disclosure notice regarding employee or independent contractor status of direct care workers and the resultant tax and insurance obligations and other responsibilities.

A review of CR #7 on 9/17/2018 at approximately 1:09 PM revealed start of services 8/1/2018. No documentation was provided by the agency to confirm the consumer/consumer representative was provided an information packet containing the following:
1. The services to be provided and the identity of the direct care worker who would provide services.
2. The hours when services would be provided.
3. Who to contact at the Department of Health for information about regulations and/or home care agency/registry compliance.
4. The Department of Health's complaint hotline.
5. The local Area Agency on Aging's Ombudsman Program telephone number.
6. The hiring and competency requirements of direct care workers.
7. The consumer disclosure notice regarding employee or independent contractor status of direct care workers and the resultant tax and insurance obligations and other responsibilities.

A review of CR #9 on 9/17/2018 at approximately 1:25 PM revealed start of services 2/8/2018. No documentation was provided by the agency to confirm the consumer/consumer representative was provided an information packet containing the following:
1. The services to be provided and the identity of the direct care worker who would provide services.
2. The hours when services would be provided.
3. Who to contact at the Department of Health for information about regulations and/or home care agency/registry compliance.
4. The Department of Health's complaint hotline.
5. The local Area Agency on Aging's Ombudsman Program telephone number.
6. The hiring and competency requirements of direct care workers.
7. The consumer disclosure notice regarding employee or independent contractor status of direct care workers and the resultant tax and insurance obligations and other responsibilities.

A review of CR #10 on 9/17/2018 at approximately 1:28 PM revealed start of services 1/17/2018. No documentation was provided by the agency to confirm the consumer/consumer representative was provided an information packet containing the following:
1. The services to be provided and the identity of the direct care worker who would provide services.
2. The hours when services would be provided.
3. Who to contact at the Department of Health for information about regulations and/or home care agency/registry compliance.
4. The Department of Health's complaint hotline.
5. The local Area Agency on Aging's Ombudsman Program telephone number.
6. The hiring and competency requirements of direct care workers.
7. The consumer disclosure notice regarding employee or independent contractor status of direct care workers and the resultant tax and insurance obligations and other responsibilities.

An exit interview was conducted with the director on 9/17/2018, at approximately 1:40 PM which confirmed the above findings.







Plan of Correction:

On 9/20/2018, agency owner visited the homes of CR1, CR2, CR3, CR4, CR5, CR6, CR7, CR9 and CR10. A copy of the following were scanned and placed in the clients' files within the office which provide the following information:
* Client Services Agreement which include:
* The services which will be provided.
* The hours the client chose that will be provided.
*The Local Resources Manual which includes the phone number and contact information on home care regulations and agency/registry compliance. It also includes the local Area Agency on Aging's Ombudsman Program and phone number.
* A printed monthly schedule of days and times along with the name(s) of the direct care worker(s).
* How To File A Complaint document with the contact information of phone numbers for the Pennsylvania Department of Health and of the local Area Agency of Aging.

*The Welcome Letter and Welcome To Home Care document which explains our hiring and competency requirements for all direct care workers.

*The signed consumer disclosure notice regarding employee or independent contractor status of direct care workers and tax and insurance obligations.
*The Billing Explanation document which explains tax obligations and third party payors.
The original documents were left in the client book in the home.

In order to guarantee the client files have all required and signed information, a policy was updated on 9/28/18 and added to the Staff Policy Manual.
Training will be offered to all office staff to ensure compliance related to client files and their contents.



Initial Comments:


Based on the findings of an onsite unannounced relicensure survey completed on 9/17/2018, Home Special Care LLC was found to be in compliance with the following requirements of 35 P.S. 448.809 (b).





Plan of Correction: