Initial Comments:
Based on the findings of an onsite unannounced state re-licensure survey conducted on September 20, 2021, Reliable Caregivers, Inc., was found to be in compliance with the requirements of 28 Pa. Code, Health Facilities, Part IV, Chapter 51, Subpart A.
Plan of Correction:
Initial Comments:
Based on the findings of an onsite unannounced state re-licensure survey conducted on September 20, 2021, Reliable Caregivers, Inc., was found not to be in compliance with the requirements of 28 Pa. Code, Health Facilities, Part IV, Chapter 611, Subpart H. 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 a review of personnel files (PF) and an interview with the administrator, the agency failed to provide documentation of an interview for seven (7) of eight (8) PF's, (PF # 1, 2, 3, 5, 6, 7, and 8); and the agency failed to obtain at least two satisfactory and verifiable references for five (5) of eight (8) PF's, (PF #1, 2, 6, 7, and 8).
Findings include:
A review of PF's was conducted on September 20, 2021 from approximately 10:10 am to 10:45 am.
PF #1, Date of Hire: 11/13/2020, did not contain any documentation of an interview and did not contain any documentation of at least two satisfactory and verifiable references.
PF #2, Date of Hire: 6/22/19, did not contain any documentation of a face to face interview and did not contain any documentation of at least two satisfactory and verifiable references.
PF #3, Date of Hire: 11/28/18, did not contain any documentation of a face to face interview.
PF #5, Date of Hire: 9/22/16, did not contain any documentation of a face to face interview.
PF #6 Date of Hire: 12/2/19, did not contain any documentation of a face to face interview and did not contain any documentation of at least two satisfactory and verifiable references.
PF #7, Date of Hire: 8/6/19, did not contain any documentation of a face to face interview and did not contain any documentation of at least two satisfactory and verifiable references.
PF #8, Date of Hire: 1/20/2020, did not contain any documentation of an interview and contained documentation of only one satisfactory and verifiable reference.
An interview with the administrator on September 20, 2021 at approximately 11:30 am confirmed the above findings.
Plan of Correction:Reliable Caregivers, Inc. will modify all policies to ensure that all employees will comply with the rules and regulations in accordance with the requirements of chapter 611.52.
In addition, an office manager will be assigned to identify the deficiencies before they occur, and/or recur.
The office manager will monitor all files on a monthly basis to prevent inaccuracies and to ensure all files are in compliance with chapter 611.1
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 a review of personnel files (PF) and an interview with the director, the agency failed to provide documentation of an annual competency evaluation for three (3) of eight (8) PF's, (PF #2, 7, and 8).
Findings include:
A review of PF's was conducted on September 20, 2021 from approximately 10:10 am to 10:45 am.
PF #2, Date of Hire: 6/22/19, did not contain any documentation of an annual competency evaluation for 2021.
PF #7, Date of Hire: 8/16/19, did not contain any documentation of an annual competency evaluation for 2021.
PF #8, Date of Hire: 1/20/2020, did not contain any documentation of an annual competency evaluation for 2021.
An interview with the director on September 20, 2021 at approximately 11:45 am confirmed the above findings.
Plan of Correction:Reliable Caregivers, Inc. will make certain that all employees will adhere to the new actions and system changes that the office manager will establish.
By enforcing these changes, Reliable Caregivers, Inc. will comply with applicable professional licensing standards which are in compliance with chapter 611.51 and required by federal, state, and local authorities.
611.56(a) LICENSURE
Health Screening
Name - Component - 00
(a) A home care agency or home care registry shall insure that each direct care worker and other office staff or contractors with direct consumer contact, prior to consumer contact, provide documentation that the individual has been screened for and is free from active mycobacterium tuberculosis.
Observations:
Based on a review of personnel files (PF), Centers for Disease Control Guidelines, and an interview with the administrator, the agency failed to provide documentation that the individual has received baseline tuberculosis screening upon hire for seven (7) of eight (8) PF's, (PF #1, 2, 3, 5, 6, 7, and 8).
Findings include:
In May 2019, the CDC updated its recommendations for TB testing of health care personnel. The CDC guidelines state that all Health Care Workers (HCW) should: 1: receive baseline tuberculosis screening upon hire by using: a two-step tuberculin skin test (TST), a single blood assay for tuberculosis (TB), or a negative chest x-ray to test for infection with tuberculosis. 2. Completion of a tuberculosis symptom questionnaire. And 3. Completion of a tuberculosis risk assessment. After baseline testing for infection with tuberculosis, HCWs should receive TB education annually. HCWs with a baseline positive test for tuberculosis infections should receive one chest radiograph result to exclude tuberculosis disease. CDC Guidelines for preventing the transmission of Mycobacterium tuberculosis in health care settings, 2005. Morbidity and Mortality World Report 2005;(5-16-19)
A review of PF's was conducted on September 20, 2021 from approximately 10:10 am to 10:45 am.
PF #1, Date of Hire: 11/35/2020, contained documentation of a Quantum Gold tuberculosis blood test, but did not contain any documentation of a completed symptom questionnaire or a completed risk assessment.
PF #2, Date of Hire: 6/22/19, did not contain any documentation that the individual had received baseline tuberculosis screening upon hire.
PF #3, Date of Hire: 11/28/18, did not contain any documentation that the individual had received baseline tuberculosis screening upon hire.
PF #5, Date of Hire: 9/22/16, contained documentation of a negative chest x-ray, but did not contain any documentation of a completed symptom questionnaire on hire.
PF #6, Date of Hire: 12/2/19, contained documentation of a Quantum Gold tuberculosis blood test, but did not contain any documentation of a completed symptom questionnaire or a completed risk assessment.
PF #7, Date of Hire: 8/6/19, did not contain any documentation that the individual had received baseline tuberculosis screening upon hire.
PF #8, Date of Hire: 1/20/2020, did not contain any documentation that the individual had received baseline tuberculosis screening upon hire.
An interview with the administrator on September 20, 2021 at approximately 11:30 am confirmed the above findings.
Plan of Correction:Reliable Caregivers, Inc. will make certain that the new policies are in place and will be monitored once a month to ensure that everyone is in compliance with chapter 611.56.
The office manager will ensure that each care worker and office staff with direct consumer contact will provide documentation that the individual has been screened and is free from active Mycobacterium Tuberculosis.
611.56(b) LICENSURE
Health Screening
Name - Component - 00
(b) A home care agency or home care registry shall require each direct care worker, and other office staff or contractors with direct consumer contact, to update the documentation required under subsection (a) at least every 12 months and provide the documentation to the agency or registry. The 12 months must run from the date of the last evaluation. The documentation required under subsection (a) shall be included in the individual's file.
Observations:
Based on review of personnel files (PFs), the Centers for Disease Control guidelines, and interview with the administrator, the agency failed to ensure each direct care worker and other office staff or contractors with direct consumer contact, were provided with annual mycobacterium tuberculosis education for six (6) of eight (8) PF's reviewed, (PF# 2, 3, 4, 5, 7, and 8)
Findings include:
In May 2019, the CDC updated its recommendations for TB testing of health care personnel. The CDC guidelines state that all Health Care Workers (HCW) should: 1: receive baseline tuberculosis screening upon hire by using: a two-step tuberculin skin test (TST), a single blood assay for tuberculosis (TB), or a negative chest x-ray to test for infection with tuberculosis. 2. Completion of a tuberculosis symptom questionnaire. And 3. Completion of a tuberculosis risk assessment. After baseline testing for infection with tuberculosis, HCWs should receive TB education annually. HCWs with a baseline positive test for tuberculosis infections should receive one chest radiograph result to exclude tuberculosis disease. CDC Guidelines for preventing the transmission of Mycobacterium tuberculosis in health care settings, 2005. Morbidity and Mortality World Report 2005;(5-16-19)
A review of PF's was conducted on September 20, 2021 between approximately 10:10 am to 10:45 am.
PF #2, Date of Hire: 6/22/19, did not contain any documentation of annual tuberculosis education provided for 2020 and 2021.
PF #3, Date of Hire: 11/28/18, did not contain any documentation of annual tuberculosis education provided for 2019 and 2020.
PF #4, Date of Hire: 10/20/11, did not contain any documentation of annual tuberculosis education provided for 2019 and 2020.
PF #5, Date of Hire: 9/22/16, did not contain any documentation of annual tuberculosis education provided for 2019 and 2020.
PF #6, Date of Hire: 12/2/19, did not contain any documentation of annual tuberculosis education provided for 2020.
PF #7, Date of Hire: 8/6/19, did not contain any documentation of annual tuberculosis education provided for 2020 and 2021.
PF #8, Date of Hire: 1/20/2020, did not contain any documentation of annual tuberculosis education provided for 2021.
An interview with the administrator conducted on September 20, 2021 at approximately 11:30 am confirmed the above findings.
Plan of Correction:Reliable Caregivers, Inc. will make certain that the new policies are in place and will be monitored once a month to ensure that everyone is in compliance with chapter 611.56.
The office manager will ensure that each care worker and office staff with direct consumer contact will provide documentation that the individual has been screened and is free from active Mycobacterium Tuberculosis.
Reliable Caregivers, Inc. will make sure to provide an annual Mycobacterium Tuberculosis education in compliance with chapter 611.56.
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 consumer files (CF) and an interview with the administrator, the agency failed to provide documentation that the consumer received information stating the agency will provide at least 10 calendar days advance written notice of the agency's intent to terminate services for seven (7) of seven (7) CF's, (CF # 1, 2, 3, 4, 5, 6, and 7).
Findings include:
A review of CF's was conducted on September 20, 2021 from approximately 9:55 am to 10:15 am.
CF #1. Start of Care: 11/12/2020, did not contain any documentation stating the consumer received information stating the agency will provide at least 10 calendar days advance written notice of the agency's intent to terminate services.
CF #2, Start of Care: 1/21/19, did not contain any documentation stating the consumer received information stating the agency will provide at least 10 calendar days advance written notice of the agency's intent to terminate services.
CF #3, Start of Care: 1/29/15, did not contain any documentation stating the consumer received information stating the agency will provide at least 10 calendar days advance written notice of the agency's intent to terminate services.
CF #4, Start of Care: 4/1/2020, did not contain any documentation stating the consumer received information stating the agency will provide at least 10 calendar days advance written notice of the agency's intent to terminate services.
CF #5, Start of Care: 8/6/19, did not contain any documentation stating the consumer received information stating the agency will provide at least 10 calendar days advance written notice of the agency's intent to terminate services.
CF #6, Start of Care: 11/29/18, did not contain any documentation stating the consumer received information stating the agency will provide at least 10 calendar days advance written notice of the agency's intent to terminate services.
CF #7, Start of Care: 8/27/18, did not contain any documentation stating the consumer received information stating the agency will provide at least 10 calendar days advance written notice of the agency's intent to terminate services.
An interview with the administrator on September 20, 2021 at approximately 11:30 am confirmed the above findings.
Plan of Correction:The office manager will make sure that all the consumer files will contain at least 10 calendar days in advance written notice of termination as stated in chapter 611.57. In addition, the manager will monitor it once a month for accuracy.
611.57(b) LICENSURE
Prohibitions
Name - Component - 00
(b) No individual as a result of the individual's affiliation with a home care agency or home care registry may assume power of attorney or guardianship over a consumer utilizing the services of that home care agency or home care registry. The home care agency or home care registry may not require a consumer to endorse checks over to the home care agency or home care registry.
Observations:
Based on a review of consumer files (CF) and an interview with the administrator, the agency failed to provide documentation that the consumer received information stating that no individual as a result of the individual's affiliation with the agency may assume power of attorney or guardianship over a consumer utilizing the services of the agency and that the agency may not require a consumer to endorse checks over to the agency for seven (7) of seven (7) CF's, (CF # 1, 2, 3, 4, 5, 6, and 7).
Findings include:
A review of CF's was conducted on September 20, 2021 from approximately 9:55 am to 10:15 am.
CF #1, Start of Care: 11/12/2020 did not contain any documentation stating the consumer received information stating no individual as a result of the individual's affiliation with the agency may assume power of attorney or guardianship over a consumer utilizing the services of the agency and that the agency may not require a consumer to endorse checks over to the agency.
CF #2, Start of Care: 1/21/19, did not contain any documentation stating the consumer received information stating no individual as a result of the individual's affiliation with the agency may assume power of attorney or guardianship over a consumer utilizing the services of the agency and that the agency may not require a consumer to endorse checks over to the agency.
CF #3, Start of Care: 1/29/15, did not contain any documentation stating the consumer received information stating no individual as a result of the individual's affiliation with the agency may assume power of attorney or guardianship over a consumer utilizing the services of the agency and that the agency may not require a consumer to endorse checks over to the agency.
CF #4, Start of Care: 4/1/2020, did not contain any documentation stating the consumer received information stating no individual as a result of the individual's affiliation with the agency may assume power of attorney or guardianship over a consumer utilizing the services of the agency and that the agency may not require a consumer to endorse checks over to the agency.
CF #5, Start of Care: 8/6/19, did not contain any documentation stating the consumer received information stating no individual as a result of the individual's affiliation with the agency may assume power of attorney or guardianship over a consumer utilizing the services of the agency and that the agency may not require a consumer to endorse checks over to the agency.
CF #6, Start of Care: 11/29/18, did not contain any documentation stating the consumer received information stating no individual as a result of the individual's affiliation with the agency may assume power of attorney or guardianship over a consumer utilizing the services of the agency and that the agency may not require a consumer to endorse checks over to the agency.
CF #7, Start of Care: 8/27/18, did not contain any documentation stating the consumer received information stating no individual as a result of the individual's affiliation with the agency may assume power of attorney or guardianship over a consumer utilizing the services of the agency and that the agency may not require a consumer to endorse checks over to the agency.
An interview with the administrator on September 20, 2021 at approximately 11:30 am confirmed the above findings.
Plan of Correction:The office manager will continue to enforce that the files contain documentation of the prohibitions of the power of attorney as stated in Chapter 611.57 clause (b).
The office manager will monitor all files once a month for accuracy.
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 consumer files (CF) and an interview with the administrator, the agency failed to provide information that the consumer received information stating: who to contact at the Department for information about licensure requirements for the agency and the telephone number of the Ombudsman Program located with the local Area Agency on Aging (AAA) for seven (7) of seven (7) CF's reviewed, (CF #1, 2, 3, 4, 5, 6, and 7). The agency also failed to provide documentation that the consumer received information stating documentation of 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 for four (4) of seven (7) CF's, (CF #4, 5, 6, and 7).
Findings include:
A review of CF's was conducted on September 20, 2021 from approximately 9:55 am to 10:15 am.
CF #1, Start of Care: 11/12/2020 did not contain any documentation that the agency provided information stating who to contact at the Department for information about licensure requirements for the agency and the telephone number of the Ombudsman Program located with the local Area Agency on Aging (AAA).
CF #2, Start of Care: 1/21/19 did not contain any documentation that the agency provided information who to contact at the Department for information about licensure requirements for the agency and the telephone number of the Ombudsman Program located with the local Area Agency on Aging (AAA).
CF #3, Start of Care: 1/29/15 did not contain any documentation that the agency provided information stating who to contact at the Department for information about licensure requirements for the agency and the telephone number of the Ombudsman Program located with the local Area Agency on Aging (AAA).
CF #4, Start of Care: 4/1/2020 did not contain any documentation that the agency provided information stating who to contact at the Department for information about licensure requirements for the agency, the telephone number of the Ombudsman Program located with the local Area Agency on Aging (AAA), and 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.
CF #5, Start of Care: 8/6/19 did not contain any documentation that the agency provided information stating who to contact at the Department for information about licensure requirements for the agency, the telephone number of the Ombudsman Program located with the local Area Agency on Aging (AAA), and 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.
CF #6, Start of Care: 11/29/18, did not contain any documentation that the agency provided information stating who to contact at the Department for information about licensure requirements for the agency, the telephone number of the Ombudsman Program located with the local Area Agency on Aging (AAA), and 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.
CF #7, Start of Care: 8/27/18, did not contain any documentation that the agency provided information stating who to contact at the Department for information about licensure requirements for the agency, the telephone number of the Ombudsman Program located with the local Area Agency on Aging (AAA), and 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.
An interview with the administrator on September 20, 2021 at approximately 11:30 am confirmed the above findings.
Plan of Correction:Reliable Caregivers, Inc. will ensure that documentation is provided in each consumer file of who to contact at the Department for information regarding licensure requirements.
Reliable Caregivers, Inc. will also provide the number for the complaint hotline.
The office manager will determine the success of our services by conducting monthly inspection of all files.
a) Ensure that the needs and expectations are met.
b) Guarantee that all employees meet or exceed threshold in all areas.
c) Achieve our aspiration to excellence in all that we do.
d) Embody our commitment to reflective practice and continuous improvement. The corrective action will be in compliance with chapter 611.57.
The corrective action will be reviewed and completed on Friday, November 19, 2021.
Initial Comments:
Based on the findings of an onsite unannounced state re-licensure survey conducted on September 20, 2021, Reliable Caregivers, Inc., was found to be in compliance with the requirements of 35 P.S. 448.809 (b).
Plan of Correction:
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