QA Investigation Results

Pennsylvania Department of Health
CAREGIVERS AMERICA, LLC
Health Inspection Results
CAREGIVERS AMERICA, LLC
Health Inspection Results For:


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Initial Comments:

Based on the findings of an on-site home care agency state complaint investigation survey completed 5/21/24 Caregivers America, LLC 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 on-site home care agency state complaint investigation survey completed 5/21/24, Caregivers America, LLC 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:




611.57(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 the consumer handbook, review of policies and procedures, agency documentation, consumer records (CR) reviews and interview with the Regional Manager the agency failed to provide services with reasonable accommodation of individual needs and preference for one (1) of three (3) consumer records (CR) reviewed CR#1

Findings included:

Review of the consumer handbook on 5/20/24 at 12:00 PM revealed the following information provided to clients:

"Consumer Bill of Rights & Responsibilities 1. The right to complete, current information about your care, treatment, and rights in terms you and your family can understand. 2. The right to be involved in the service planning process ...4. The right to know of changes in your services/care before those changes occur. "

Review of policy Back up contingency plan on 5/21/24 at 9:00 AM states, "Procedure...2. If the HCP/ISP cannot be followed because the regular direct care worker in unavailable, the company will institute one of the following back up/contingency plans. Individuals and their families will be made aware of these plans upon start of service In the New Consumer Packet...c. if qualified individuals cannot be located for that time period, the care coordinators will be responsible for performing as the direct care worker for the time time period specified; or d. In emergency situations where a Care Coordinator or other qualified individual is unable to provide services. the identified natural support person will be notified so they can provide natural supports to the individual. This will be considered a last resort/emergency-only option."

CR#1 Start of service 6/14/19. The most recent authorization on 8/31/23 revealed the consumer was to receive 168 hours per week, equating to 24 hours a day/7 days per week.
There was no documentation listing a back-up caregiver.
Documentation showed from 4/20/24-5/21/24 743.33 hours were scheduled but only 635.24 had been billed.

Interview with the Regional Manager and Pennsylvania Quality Manger on 5/20/24 at approximately 1:00 PM confirmed the above findings.








Plan of Correction:

The local branch staff will re-do the Home Care Plan (HCP) to match the most recent service authorization. The updated HCP will identify an emergency contact for the consumer, preferred schedule, and caregiver assigned. The local branch staff will also get a new Acknowledgement Disclosure Form signed with a specific natural support as determined by the consumer.

All employees that play a role in the start of care or change in authorization process will receive training to reeducate on frequency of care, consumer's right to be involved in their service planning process, consumer's right to know of changes in care/schedule before they occur, communication with case manager and/or family and proper steps to initiate the back-up-plan.

To ensure ongoing compliance after the Corrective Action Date the Regional Manager will randomly review two consumers per month to be sure the proper frequency of care is being met or the proper process for covering or canceling a shift and the proper documentation to support such action has been done and enforce internal plans of correction whenever applicable.


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 agency documentation, consumer records (CR) reviews and interview with the Regional Manager it was determined the agency failed to notify consumers of the identity of the direct care worker who will be providing services for one (1) of three (3) CR reviewed (CR#1)

Findings include:

Review of the consumer handbook on 5/20/24 at 12:00 PM revealed the following information provided to clients:

" Consumer Bill of Rights & Responsibilities 1. The right to complete, current information about your care, treatment, and rights in terms you and your family can understand. 2. The right to be involved in the service planning process ...4. The right to know of changes in your services/care before those changes occur. "

Review of consumer files (CR) on 5/20/24 at approximately 11:00 AM revealed the following:

CR #1 start of service 6/14/19 failed to contain documentation that the consumer was made aware of the identity of the direct care worker who will be providing services. There was no personnel records for the caregivers listed as being assigned on the consumer's home care plan dated 6/14/19. There was no additional documentation noting the client was made aware of the identity of any caregivers that would be providing services.

Interview with the Regional Manager and Pennsylvania Quality Manger on 5/20/24 at approximately 1:00 PM confirmed the above findings.






Plan of Correction:

The local branch staff will re-do the Home Care Plan (HCP) to match the most recent service authorization. The updated HCP will identify an emergency contact for the consumer, preferred schedule, and caregiver assigned.

All employees that play a role in the scheduling/change in schedule process will receive training to reeducate on the agency's commitment and steps taken to exhaust all efforts to cover a shift prior to canceling the shift, the consumer's right to be involved in their service planning process, consumer's right to know of changes in care/schedule/caregiver before they occur, communication with case manager and/or family about the change when applicable, and how to initiate the back-up-plan.

To ensure ongoing compliance after the Corrective Action Date the Regional Manager will check five cancelled visits per month confirming the agency exhausted all efforts to cover a shift prior to cancelling the shift and the proper documentation to support such action has been done and enforce internal plans of correction whenever applicable.