QA Investigation Results

Pennsylvania Department of Health
A1 HOMECARE, INC.
Health Inspection Results
A1 HOMECARE, INC.
Health Inspection Results For:


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Initial Comments:

Based on the findings of an onsite unannounced state re-licensure survey conducted on November 22, 2022, A1 Homecare, 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 home care agency state re-licensure survey conducted on November 22, 2022, A1 Homecare, 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:




611.56(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 upon review of personnel files (PF) and an interview with the agency administrator, the agency failed to ensure annual tuberculosis (TB) training was conducted for seven (7) of ten (10) PF reviewed (employed more than one year). (PF#1, 2, 3, 5, 6, 7, and 10).

Findings Include:

The CDC (Center for Disease and Control) guidelines state baseline (preplacement) screening and testing, in addition to the IGRA (interferon-gamma release assay) or tuberculin skin test (TST), shall include a symptom screen questionnaire and an individual tuberculosis (TB) risk assessment. Serial screening and testing not routinely recommended. Annual TB education is recommended. (CDC/MMWR/May 17, 2019/Vol. 68/No. 19).

Review of PF conducted on November 22, 2022, from approximately 10:45 A.M. to 11:45 A.M. revealed the following:

PF #1, date of hire May 4, 2020, contained no documentation of completion of annual TB training.

PF #2, date of hire August 13, 2020, contained no documentation of completion of annual TB training.

PF #3, date of hire June 2, 2020, contained no documentation of completion of annual TB training.

PF #5, date of hire March 12, 2019, contained no documentation of completion of annual TB training.

PF #6, date of hire March 23, 2021, contained no documentation of completion of annual TB training.

PF #7, date of hire March 11, 2020, contained no documentation of completion of annual TB training.

PF #10, date of hire August 19, 2021, contained no documentation of completion of annual TB training.

An interview with the agency administrator on November 22, 2022, at approximately 12:00 P.M. confirmed the above findings.


























Plan of Correction:

1 How the agency will correct the deficiency

Based on the findings of non-compliance with the requirements of 28 Pa. Code, Health Facilities, Part IV, Chapter 611, Subpart H, Home Care Agencies and Home Care Registries, 611.56(a) Health Screening during an on-site survey by the Department of Health, A1 Homecare, Inc. (A1HC) will update both, its TB Screening Tool to include questions consistent with the CDC recommendation for TB screening and will implement an annual TB Training for all of its employees with a customer facing role. Bothe the screening and training will be completed during on-boarding of all new employees prior to scheduling them in their customer facing roles and annually thereafter, to be completed prior to their 1 year anniversary of the previous TB screening and training.

2 How the agency will protect patients in similar situations

The agency will add a requirement to review the employees last PPD screening and training date every time an employee is scheduled with new patients. That date will be written on the service order given to the employee at the commencement of a newly assigned patient and will have to be less than 1 year old. If the date is over one year old, that employee may not be scheduled with any patient until they have successfully completed their TB screening and training.

3 Measures taken by agency to ensure problem does not recur

By implementing a new policy of annual TB trainings and a protocol for administering the TB trainings along with checks and balance to ensure only staff with current TB screening trainings are scheduled with patients, the agency will ensure this problem will not recur.

4 How will the agency monitor its performance

Director of HR will be responsible for completing the mandatory TB screening and training at time of on-boarding and annually thereafter. Agency Director will be responsible for quarterly random screenings of staff files to ensure all client facing staff have completed their initial and annual TB screening and training.

5 Date for corrective action completion

The agency will complete the annual TB screening and training for staff identified in personnel files 1, 2, 3, 5, 6, 7 and 10 by January 21, 2023 as required for Corrective Action Plans, and will implement the annual TB screening and training for all staff prior to their 1 year anniversary of their TB screening



Initial Comments:

Based on the findings of an onsite unannounced home care agency state re-licensure survey conducted on November 22, 2022, A1 Homecare, Inc. was found to be in compliance with the requirements of 35 P.S. 448.809 (b).



Plan of Correction: