Initial Comments:
Based on the findings of an onsite state re-licensure survey conducted on August 1, 2024, 1 Your Health Matters, 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 onsite state re-licensure survey conducted on August 1, 2024, 1 Your Health Matters, 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:
611.56(a) LICENSURE
Health Screening
Name - Component - 00
The screening shall be conducted in accordance with CDC guidelines for preventing the transmission of mycobacterium tuberculosis in health care settings. The documentation must indicate the date of the screening which may not be more than 1 year prior to the individual's start date.
Observations:
Based on review of personnel files (PF), Centers for Disease and Control (CDC) guidelines, and interview with the Director and Administrator, it was determined that personnel files did not include documentation that TB testing, TB risk assessments, and TB symptom screens were conducted at time of hire or prior to assigning direct care workers (DCW) to consumers, for eight (8) of eight (8) personnel files reviewed. (PF1, PF2, PF3, PF4, PF5, PF6, PF7, and PF8)
Findings Include:
"Tuberculosis Screening, Testing, and Treatment of U.S. Health Care Personnel: Recommendations from the National Tuberculosis Controllers Association and CDC, 2019 - Historically, U.S. health care personnel were at increased risk for latent TB infection (LTBI) and TB disease from occupational exposures, but recent data suggest that this is no longer the case. CDC and the National Tuberculosis Controllers Association have updated the 2005 CDC recommendations for testing health care personnel. The update includes 1) TB risk assessment, symptom screening, and TB testing upon hire with a TB blood test (e.g., interferon-gamma release assay) or tuberculin skin test for those without documented prior TB or LTBI; 2) no annual TB testing for most health care personnel without a known exposure or ongoing transmission; 3) for health care personnel with LTBI treatment is strongly encouraged; 4) annual symptom screening for health care personnel with untreated LTBI; and 5) annual TB education for all health care personnel. These recommendations apply to health care personnel and volunteers in all health care settings. However, state and local TB screening and testing regulations may have different requirements."
Review of personnel files (PF) was conducted on 8/1/2024 from approximately 11:02AM until approximately 12:50PM revealed:
PF1 - (Date of Hire): 10/20/2023 - File contained results of a Chest X-ray dated 1/24/2023. File did not contain documentation that a TB risk assessment and TB symptom screen were conducted at time of hire or prior to assigning direct care worker (DCW) to consumers.
PF2 - (Date of Hire): 10/14/2021 - File contained a 1-Step PPD skin test dated 10/4/2021 and a 2nd PPD skin test dated 10/6/2021. File did not contain documentation that a TB risk assessment and TB symptom screen were conducted at time of hire or prior to assigning direct care worker (DCW) to consumers, and there was no documentation of annual TB education for 2022 and 2023.
PF3 - (Date of Hire): 3/22/2023 - File contained results of a Chest X-ray dated 1/24/2020. File did not contain documentation that a TB risk assessment and TB symptom screen were conducted at time of hire or prior to assigning direct care worker (DCW) to consumers.
PF4 - (Date of Hire): 5/16/2024 - File contained results of a QuantiFERON Gold blood test dated 6/7/2023. File did not contain documentation that a TB risk assessment and TB symptom screen were conducted at time of hire or prior to assigning direct care worker (DCW) to consumers.
PF5 - (Date of Hire): 10/27/2022 - File contained results of a Chest X-ray dated 10/21/2022. File did not contain documentation that a TB risk assessment and TB symptom screen were conducted at time of hire or prior to assigning direct care worker (DCW) to consumers, and there was no documentation of annual TB education for 2023.
PF6 - (Date of Hire): 3/18/2024 - File contained results of a QuantiFERON Gold blood test dated 3/7/2024. File did not contain documentation that a TB risk assessment and TB symptom screen were conducted at time of hire or prior to assigning direct care worker (DCW) to consumers.
PF7 - (Date of Hire): 5/7/2024 - File contained a 1-Step PPD skin test dated 4/19/2024 and a 2nd PPD skin test dated 4/26/2024. File did not contain documentation that a TB risk assessment and TB symptom screen were conducted at time of hire or prior to assigning direct care worker (DCW) to consumers.
PF8 - (Date of Hire): 5/20/2022 - File contained a 1-Step PPD skin test and TB risk assessment both dated 7/25/2024, which is more than two (2) years after hire. File did not contain documentation that TB testing, TB risk assessment, and TB symptom screen were conducted at time of hire or prior to assigning direct care worker (DCW) to consumers. File did not contain documentation of annual TB education for 2023.
An interview with the Director and Administrator on 8/1/2024 at approximately 1:05PM confirmed the above findings.
Plan of Correction:- Ensure that all direct care workers who lack documented evidence of baseline screening for tuberculosis using a two-step tuberculin skin test (TST) or an interferon-gamma release assay (IGRA) are evaluated.
- Implement a symptom screen questionnaire and individual TB risk assessment for each direct care worker.
- Provide annual tuberculosis (TB) education for all direct care workers with direct consumer contact.
- Revise policies and procedures to include requirements for annual TB education for all employees.
Initial Comments:
Based on the findings of an onsite state re-licensure survey conducted on August 1, 2024, 1 Your Health Matters, LLC, was found to be in compliance with the requirements of 35 P.S. 448.809(b).
Plan of Correction:
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