Initial Comments:
Based on the findings of an onsite state re-licensure survey conducted on April 7, 2025, Altruistic Home Care Agency, 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 state re-licensure survey conducted on April 7, 2025, Altruistic Home Care Agency, was found to not 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
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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 agency administrator and staff, the agency failed to conduct a face-to-face interview and/or obtain two (2) satisfactory references prior to hiring or rostering for four (4) of the seven (7) PF's reviewed. (PF#1, PF#2, PF#4, and PF#7)
Findings include:
Personnel file review conducted April 7, 2025, from approximately 1:15 pm to 3:15 pm revealed the following:
PF #1 Date of hire (DOH), 6/13/24: Did not contain documentation of a face-to-face or two (2) satisfactory references obtained prior to the hire date. Face to face and references dated 6/22/24, after the hire date.
PF#2 DOH 3/18/24: Did not contain documentation of a face-to-face or two (2) satisfactory references obtained prior to the hire date. Face to face dated 3/30/24. No documentation of verified references on file.
PF#4 DOH 6/30/23: Did not contain documentation of a face-to-face or two (2) satisfactory references obtained prior to the hire date. Face to face and references dated 7/1/23, after the hire date.
PF#7 DOH 2/9/21: Did not contain documentation of a face-to-face or two (2) satisfactory references obtained prior to the hire date. Face to face and references dated 3/1/21, after the hire date.
An interview with the administrator and staff conducted on April 7, 2025, at approximately 3:15PM confirmed the above.
Plan of Correction:Altruistic home care agency will interview every caregiver face-to-face before they start rendering services.
We will obtain two satisfactory references before the caregiver commences work.
611.55(a) LICENSURE
Competency Requirements
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Prior to assigning or referring a direct care worker to provide services to a consumer, the home care agency or home care registry shall ensure that the direct care worker has done one of the following: (1) Obtained a valid nurse ' s license in this Commonwealth;
(2) Demonstrated competency by passing a competency examination developed by the home care agency or home care registry which meets the requirements of subsection (b)and (c).
(3) Has successfully completed one of the following:
(i) A training program developed by a home care agency, home care registry, or other entity which meets the requirements of subsection (b) and (c).
(ii) A home health aide training program meeting the requirements of 42 C.F.R. 484.36 (relating to the Conditions of Participation; Home Health Aide Services).
(iii) The nurse aid certification and training program sponsored by the Department of Education and located at www.pde.state.pa.us.
(iv) A training program meeting the training standards imposed on the agency or registry by virtue of the agency ' s or registry ' s participation as a provider in a Medicaid waiver or other publicly funded program providing home and community based services to qualifying consumers.
(v) Another program identified by the Department by subsequent publication in the Pennsylvania Bulletin or on the Department ' s website.
Observations:
Based on review of personnel files (PF), and an interview with the agency administrator, it was determined the agency failed to demonstrate, prior to assigning or referring the direct care worker to provide services to a consumer, competency by passing an initial competency examination for three (3) of seven (7) PF reviewed. (PF#1, PF#4 and PF#7)
Findings include:
Personnel file review conducted April 7, 2025, from approximately 1:15 pm to 3:15 pm revealed the following:
PF #1 Date of hire (DOH), 6/13/24: Contained no documentation of an initial competency completed prior to assigning or referring the direct care worker to provide services to a consumer. Initial competency dated 6/22/24, after the start date.
PF#4 DOH 6/30/23: Contained no documentation of an initial competency completed prior to assigning or referring the direct care worker to provide services to a consumer. Initial competency dated 7/1/23, after the start date.
PF#7 DOH 2/9/21: Contained no documentation of an initial competency completed prior to assigning or referring the direct care worker to provide services to a consumer. Initial competency dated 2/20/21, after the start date.
An interview with the administrator and staff conducted on April 7, 2025, at approximately 3:15PM confirmed the above.
Plan of Correction:Altruistic home care agency, before assigning a caregiver to provide services, we will ensure that the caregiver has completed a training program developed by the agency, home care registry, or other entity that meets the requirements of subsections A and C
We will make sure the agency receptionist monitors the competency test
we will do an internal audit to make sure this does not recur.
The minimum score will be 85% as this will indicate their outstanding performance for the test.
611.55(e) LICENSURE
Competency Requirements
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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 personnel files (PF), and an interview with the agency administrator and staff, it was determined the agency failed to perform a competency review, which 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 for four (4) of seven (7) PF reviewed. (PF#3, PF#5, PF#6, and PF#7)
Findings include:
Personnel file review conducted April 7, 2025, from approximately 1:15 pm to 3:15 pm revealed the following:
PF#3 Date of hire (DOH), 9/20/22: Contained no documentation of an annual competency review for 2023 and 2024.
PF#5 DOH 10/2/21: Contained no documentation of an annual competency review for 2022.
PF#6 DOH 11/16/22: Contained no documentation of an annual competency review for 2023.
PF#7 DOH 2/9/21: Contained no documentation of an annual competency review for 2023 and 2024.
An interview with the administrator and staff conducted on April 7, 2025, at approximately 3:15PM confirmed the above.
Plan of Correction:Altruistic Home Care Agency will conduct a competency review at least once yearly after the initial competency is taken.
And more frequently when disciplinary or other sanctions, including but not limited to verbal warning or suspension, are imposed because of a quality of care infraction
611.56(a) LICENSURE
Health Screening
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(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 review of personnel files (PF), the Centers for Disease Control Guidelines, and an interview with the agency administrator and staff, it was determined the agency failed to ensure direct care workers were screened for and were free from active mycobacterium tuberculosis prior to assignment with clients for five (5) out of seven (7) direct personnel files reviewed. (PF #1, PF#2, PF #3, PF #4, and PF#7).
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)
Personnel file review conducted April 7, 2025, from approximately 1:15 pm to 3:15 pm revealed the following:
PF #1 Date of hire (DOH), 6/13/24: Did not contain documentation of a completed baseline tuberculosis risk and symptom assessment questionnaire upon hire. TB questionnaire dated 6/22/24, after the start date.
PF#2 DOH 3/18/24: Did not contain documentation of a completed baseline tuberculosis risk and symptom assessment questionnaire upon hire. TB questionnaire dated 3/30/24, after the start date.
PF#3 DOH 9/20/22: Did not contain documentation of a completed baseline tuberculosis risk and symptom assessment questionnaire upon hire. TB questionnaire dated 10/2/22, after the start date.
PF#4 DOH 6/30/23: Did not contain documentation of a completed baseline tuberculosis risk and symptom assessment questionnaire upon hire. TB questionnaire dated 7/1/23, after the start date.
PF#7 DOH 2/9/21: Did not contain documentation of a completed baseline tuberculosis risk and symptom assessment questionnaire upon hire. TB questionnaire dated 7/1/23, after the start date.
An interview with the administrator and staff conducted on April 7, 2025, at approximately 3:15pm confirmed the above.
Plan of Correction:Altruistic home care agency will ensure that each direct care worker, other staff member,or contractors with direct consumer contact prior to consumer contact
we will provide documentation that the individual has been screened for and free from any active Mycobacterium tuberculosis
as directed by the Centers for Disease Control
611.56(b) LICENSURE
Health Screening
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(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 and staff, 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 five (5) of seven (7) PF's reviewed, (PF#3-7).
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)
Personnel file review conducted April 7, 2025, from approximately 1:15 pm to 3:15 pm revealed the following:
PF#3 Date of hire (DOH), 9/20/22: Contained no documentation of annual TB education for 2023 and 2024.
PF#4 DOH 6/30/23: Contained no documentation of an annual TB education for 2024.
PF#5 DOH 10/2/21: Contained no documentation of annual TB education for 2022, 2023, and 2024.
PF#6 DOH 11/16/22: Contained no documentation of annual TB education for 2023 and 2024
PF#7 DOH 2/9/21: Contained no documentation of an annual TB education for 2022, 2023 and 2024
An interview with the administrator and staff conducted on April 7, 2025, at approximately 3:15pm confirmed the above.
Plan of Correction:Altruistic home care agency shall require each direct care worker and the other office staff or contractors with direct consumers to update the documentation at least once.
Based on the recommendations of the Centers for Disease Control and Prevention guidelines,
Altruistic Home Care will update its recommendation for TB testing for health care personnel.
1) Altruistic home care will receive baseline tuberculosis screening up on hiring by using a two-step tuberculin skin test (TST) a single blood assay tuberculosis (TB) or a negative chest X ray to test for infection with tuberculosis. the HCW's will receive TB education annually.
HCW's with a positive baseline test for tuberculosis infection will receive on chest rediograph result to exclude tuberculosis disease.
611.57(a) LICENSURE
Consumer Rights
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(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 records (CRs) and an interview with the administrator and staff, the agency failed to provide the consumer their rights to receive services within reasonable accommodation of individual needs for one (1) of seven (7) CRs reviewed. (CR#1)
Review of consumer records conducted on April 7, 2025, between approximately 12:00 PM and 1:15 PM revealed:
CR#1, Start of services (SOC) 6/13/24: Contained no documentation of the agency providing services to the consumer within reasonable accommodation of the individual's needs.
Service agreement signed 1/26/24. Service authorization is for seven (7) days, ten (10) hours a day. Documentation for March shows hours serviced as follows:
1. Week of March 2-8th: 23 hours and 18 minutes provided out of 70 hours agreed upon. No documentation for services provided on March 5, 2025 and March 8, 2025.
2.Week of March 9-15th: 24 hours and 45 minutes provided out out of 70 hours agreed upon.
3.Week of March 16-22nd: 24 hours and 15 minutes provided out out of 70 hours agreed upon. No documentation of services provided on March 19, 2025.
4.Week of March 23-29th: 23 hours and 54 minutes provided out out of 70 hours agreed upon. No documentation of services provided on March 27, 2025.
Contained no documentation for missed hours notification or any communication to the service coordinator regarding missed hours/visits.
An interview with the administrator and staff conducted on April 7, 2025, at approximately 3:15PM confirmed the above.
Plan of Correction:Altruistic Home Care Agency will include all consumers in the care plan process and provide reasonable accommodation of individual needs and preferences. expect where the health of the caregiver is at risk
Altruistic Home Care Agency will provide at least 10 calendar days advance written notice of intent of the agency to terminate services.
We will indicate on the client care plan and give a copy to the client for their records. We will involve them at every point and also make sure they understand their rights.
The office administrator will be there to supervise during the printing to make sure this information are included
Initial Comments:
Based on the findings of an onsite state re-licensure survey conducted on April 7, 2025, Altruistic Home Care Agency, was found to not be in compliance with the requirements of 35 P.S. 448.809 (b).
Plan of Correction:
35 P. S. § 448.809b LICENSURE
Photo Id Reg
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Law amended July 11, 2022 Act 79 2022 HB 2604
(1) The photo identification tag shall include a recent
photograph of the employee, the employee's first name, the
employee's title and the name of [the health care facility or
employment agency.] any of the following:
(i) The health care facility.
(ii) The health system.
(iii) The employment agency.
(iv) The fictitious name of an entity under
subparagraph (i), (ii) or (iii) which is registered with
the Department of State under 54 Pa.C.S. Ch. 3 (relating
to fictitious names) or a successor statute.
(2) The title of the employee shall be as large as possible
in block type and shall occupy a one-half inch tall strip as
close as practicable to the bottom edge of the badge.
(3) Titles shall be as follows:
(i) A Medical Doctor shall have the title "Physician."
(ii) A Doctor of Osteopathy shall have the title
"Physician."
(iii) A Registered Nurse shall have the title
"Registered Nurse."
(iv) A Licensed Practical Nurse shall have the title
"Licensed Practical Nurse."
(v) All other titles shall be determined by the
department. Abbreviated titles may be used when the title
indicates licensure or certification by a Commonwealth
agency.
(4)A notation, marker or indicator included on an identification badge that differentiates employees with the same first name is considered acceptable in lieu of displaying an employee's last name.
Observations:
Based on observation of Identification badges (ID) and an interview with the agency's administrator and staff, the agency failed to format/issue ID badges per regulatory requirements for one (1) of one (1) observation (Observation #1).
Findings include:
Observation #1: Observation of employee Identification Badge (ID) on April 7, 2025, at approximately 3 pm., revealed the current ID badge of the employee ' s title does not occupy the bottom 1/2" of the badge as large as possible.
An interview with the administrator and staff conducted on April 7, 2025, at approximately 3:15pm confirmed the above.
Plan of Correction:Altruistic Home Care Agency will make sure all staff have the appropriate photo ID as required by law amended July 11th 2022 act 79 2022 HB 2606
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