Initial Comments:
Surveyor : Kistler-Bowman, Christina
Based on the findings of an onsite follow-up survey completed 9/18/24, Abraham Home Care had not corrected the deficiencies cited under PA Code, Title 28, Health and Safety, Part IV, Health Facilities, Subpart H, Chapter 611, Home Care Agencies and Home Care Registries. The deficiencies were cited as a result of a complaint investigation completed on 4/9/24.
Plan of Correction:
611.4(c) LICENSURE Requirements for HCA and HCR Name - Component - 00 Home care agencies and home care registries licensed under this Chapter shall comply with applicable environmental, health, sanitation and professional licensure standards which are required by Federal, State, and local authorities.
Observations:
Surveyor: Kistler-Bowman, Christina
Per 35 P.S. 448.813, "...Authorization.--For the purpose of determining the suitability of the applicants and of the premises or for determining the adequacy of the care and treatment provided or the continuing conformity of the licensees to this act and to applicable local, State and Federal regulations, any authorized agent of the department may enter, visit and inspect the building, grounds, equipment and supplies of any health care facility licensed or requiring a license under this act and shall have full and free access to the records of the facility and to the patients and employees therein and their records, and shall have full opportunity to interview, inspect, and examine such patients and employees..." Based on a review of Department records and an interview with the agency owner (EMP1) the agency failed to maintain standards required by State authorities, specifically, the agency failed to be subject to an inspection by authorized representatives of the department. Findings included: A review of Statement of Deficiencies and Plan of Correction dated 4/9/24 revealed: " S 120 611.4 (c ) Requirements for HCA and HCR Completion Date: 5/1/24 ...The owner of the agency has reviewed the findings from the Department of Health. The agency ' s office hours are Monday-Friday, 9a-4p. in the event that the office hours will change or if the office will be closed on a particular day, the agency will email the Department of Health in advance to prevent a reoccurrence of a surveyor conducting a unannounced visit and the office being unexpectedly closed. The agency will also grant access to the receptionist so that she can open the office whenever the administrator isn't available ... " A review of department records on 9/17/24 at approximately 2:45 pm in preparation for an onsite survey to be conducted on 9/18/24 found the agency operating hours to be Monday though Friday 10 am to 2 pm at the 900 Sarah Street Suite 137 Pittsburgh, Pa 15203 address. An agency phone number was also listed and verified by agency email received on 8/20/24. Surveyors attempted to conduct a scheduled onsite follow up survey on 9/18/24 at approximately 10:00 am. No staff was available to gain entry to conduct the scheduled inspection. A phone call was made to the listed agency number at 10:00 am which revealed a full mailbox. An alternate cell number for the agency owner was contacted at 10:00 am, 10:21 am, and 10:51 am and messages were left requesting a return call. Surveyors terminated the on-site survey attempt at 11:00 am on 9/18/24. A phone call was received from the agency owner (EMP1) at approximately 11:30 am and the agency owner explained he was unavailable at the scheduled survey time because he was " sleeping. "
Plan of Correction:An approved Plan of Correction is not on file.
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:
Surveyor: Kistler-Bowman, Christina
Based on an observation, department policy, a review of 4/9/24 plan of correction and an interview with the agency owner, the agency failed to maintain agency inspection standards required by the Commonwealth and provide surveyors with the ability to conduct a follow up review of consumer records for two (2) of two (2) CRs. (CRs 1-2)
Findings included: Per 35 P.S. 448.813, "...Authorization.--For the purpose of determining the suitability of the applicants and of the premises or for determining the adequacy of the care and treatment provided or the continuing conformity of the licensees to this act and to applicable local, State and Federal regulations, any authorized agent of the department may enter, visit and inspect ... and shall have full and free access to the records of the facility ... A 9/17/24 review of Statement of Deficiencies and Plan of Correction dated 4/9/24 revealed: " Completion date: 5/1/24 ...The owner of the agency has reviewed the findings from the Department of Health ...in the event that the office hours will change or if the office will be closed on a particular day, the agency will email the department in advance ...S 800 ...611.57 (a) Consumer Rights ...Completion Date 4/27/24 ...CR1 ...we would request a new authorization ...CR2 ...we will be sure to document refused shifts ...the owner of the agency will also audit all of our consumer files to be sure that they are in compliance ... " Surveyors attempted to conduct a scheduled onsite follow up survey on 9/18/24 at approximately 10:00 am. No staff was available to gain entry to conduct the scheduled inspection and consumer record review. A phone call was made to the listed agency number at 10:00 am which revealed a full mailbox. An alternate cell number for the agency owner was contacted at 10:00 am, 10:21 am, and 10:51 am and messages were left requesting a return call. Surveyors terminated the on-site survey attempt at 11:00 am on 9/18/24. A phone call was received from the agency owner (EMP1) at approximately 11:30 am and the agency owner explained he was unavailable at the scheduled survey time because he was "sleeping. "
Plan of Correction:An approved Plan of Correction is not on file.
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