Initial Comments:
Based on the findings of an onsite state re-licensure survey conducted on December 6, 2024, America's Home Care 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 state re-licensure survey conducted on December 6, 2024, America's Home Care Inc 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:
611.52(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 personnel files (PF) and an interview with the administrator, the agency did not obtain proof of residency in order to request/obtain a criminal history record through the 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 for one (1) of seven (7) PF's: PF#3)
Findings include:
Personnel file review conducted on December 6, 2024, from approximately 2pm to 4pm, revealed the following:
PF#3 Date of hire (DOH) 4/13/23: Contained a Pennsylvania drivers license issued on 8/6/22, which fails to ascertain PA residence of two (2) or more years. No other documentation on file to establish proof of residency.
An interview with the administator and the office manager on December 6, 2024 at approximately 4pm confirmed the above findings.
Plan of Correction:Provider agency will make sure to request proof of residency in the state of Pennsylvania for at least 2 years before the employment start date. This check will be performed at the very first interview and for a second time, 2 days right before the start date, to have a redundant system so we prevent this from recurring. If such documentation is not readily available, new hires will be sent for FBI fingerprinting.
The administrator will check every new hire folder one day before the start date, and sign off on a form indicating new hires satisfy PA 2 year residency requirement. Also, existing employee files, will be checked during their quarterly assessment, to make sure all residency documentation is on file.
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 review of personnel files (PF), the Centers for Disease Control Guidelines, and an interview with the agency administrator and administrative assistant, it was determined the agency failed to ensure direct care workers were screened for active mycobacterium tuberculosis prior to assignment with clients and annually for seven (7) out of seven (7) direct personnel files reviewed. (PF #1-7 ).
The CDC guidelines state that all Health Care Workers (HCW) should receive baseline tuberculosis screening upon hire, using a two-step tuberculin skin test (TST) or a single blood assay for tuberculosis (TB) to test for infection with tuberculosis. After baseline testing for infection with tuberculosis, HCWs should receive TB screening annually. HCWs with a baseline positive or newly 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; RR-17'). (http://www.cdc.gov/mmwr/pdf/rr/rr5417.pdf.)
*Baseline (preplacement) screening and testing, in addition to the IGRA (interferon-gamma release assay) or TST, shall include a symptom screen questionnaire and an individual TB risk assessment. Serial screening and testing not routinely recommended. Annual TB education is recommended. (CDC/MMWR/May 17, 2019/Vol. 68/No. 19).
Findings include:
A review of personnel files conducted on December 6, 2024, between approximately between 2pm and 4pm revealed the following:
PF#1 Date of hire (DOH) 2/22/22: Did not contain a baseline risk and symptom screening questionnaire.
PF#2 DOH 8/17/16: Did not contain a baseline risk and symptom screening questionnaire.
PF#3 DOH 4/13/23: Did not contain a baseline risk and symptom screening questionnaire.
PF#4 DOH 10/26/24: Did not contain a baseline risk and symptom screening questionnaire.
PF#5 DOH 8/14/24: Did not contain a baseline risk and symptom screening questionnaire.
PF#6 DOH 5/9/23: Did not contain a baseline risk and symptom screening questionnaire.
PF#7 DOH 10/16/14: Did not contain a baseline risk and symptom screening questionnaire.
An interview with the administator and the office manager on December 6, 2024 at approximately 4pm confirmed the above findings.
Plan of Correction:Provider agency always screens newly hired direct care workers for active mycobacterium tuberculosis prior to assignment with clients, most of the new hires opt for the single blood assay test for tuberculosis (TB). The rest of the new hires choose either the two-step tuberculin skin test (TST), and/or chest x-ray imaging. The TB baseline risk and symptom assessment will also be completed upon hire.
However, where provider has failed, is on the annual TB symptoms questionnaire screening for active TB for existing direct care workers, during their annual recert with provider agency.
Effective immediately, provider will incorporate the TB screening questionnaire in the annual training, recertification packet for all existing direct care workers, as per CDC guidelines. Annually, the TB education includes a review of the risk and symptom screens. Provider agency will also check all past files to make sure a TB screening questionnaire is part of the file for each DCW and completed during reassessment/recert of employees. The administrator will be responsible for signing off on that specific form for all new hires and existing DCW to prevent them from being missed in the future.
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 review of consumer files (CF) and an interview with the administrator and the office manager, the agency failed to provide the following information to the consumer, the consumer's legal representative, or a responsible family member prior to the start of services:
(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 for five (5) of the five (5) CF's reviewed. (CF#1-5)
Findings include:
A review of consumer files (CF) was conducted on December 6, 2024, from approximately 12 pm to 2pm revealed the following:
CF#1 Start of care (SOC) 2/25/22: Contained no documentation the consumer, the consumer's legal representative, or a responsible family member received the hiring and competency requirements applicable to direct care workers employed by the home care agency or referred by the home care registry.
CF#2 SOC 5/7/23: Contained no documentation the consumer, the consumer's legal representative, or a responsible family member received the hiring and competency requirements applicable to direct care workers employed by the home care agency or referred by the home care registry.
CF#3 SOC 4/13/23: Contained no documentation the consumer, the consumer's legal representative, or a responsible family member received the hiring and competency requirements applicable to direct care workers employed by the home care agency or referred by the home care registry.
CF#4 SOC 10/26/24: Contained no documentation the consumer, the consumer's legal representative, or a responsible family member received the hiring and competency requirements applicable to direct care workers employed by the home care agency or referred by the home care registry.
CF#5 SOC 8/14/24: Contained no documentation the consumer, the consumer's legal representative, or a responsible family member received the hiring and competency requirements applicable to direct care workers employed by the home care agency or referred by the home care registry.
An interview with the administator and the office manager on December 6, 2024 at approximately 4pm confirmed the above findings.
Plan of Correction:Effective immediately, the provider agency will incorporate into its welcome and admission packet for new consumers, documentation providing evidence to the consumer, the consumer's legal representative, or a responsible family member, of the hiring and competency requirements applicable to direct care workers employed by the home care agency.
Initial Comments:
Based on the findings of an onsite state re-licensure survey conducted on December 6, 2024, America's Home Care Inc 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
Name - Component - 00
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 administrator and office manager, agency failed to format/issue ID badges per the following regulatory requirements, for one (1) of one (1) observation (Observation #1).
Findings include:
The regulatory requirements are the following:
(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 (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.
Findings include:
Observation #1: Observation of employee Identification Badge (ID) on December 6, 2024, at approximately 3:00pm revealed the current ID badge employee title does not occupy the bottom 1/2" of the badge as large as possible. The title reads "PCA" which is not the correct title.
An interview with the administrator and the office manager on December 6, 2024, at approximately 4pm confirmed the above findings.
Plan of Correction:Provider agency will supply all Direct Care Workers (DCW) and administrative staff with new identification badges that will incorporate the following specifications:
The photo identification tag include a recent photograph of the employee, the employee's first name, the employee's title and the name of the employing provider agency. The title of the employee will be as large as possible in block type and will occupy a one-half inch 1/2" 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.
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