Initial Comments:
Based on the findings of an onsite state re-licensure survey conducted on December 15, 2023, 1st Choice Home Health Care-PA, 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 December 15, 2023, 1st Choice Home Health Care-Pa, 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
(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 a review of personnel files (PF), the Centers for Disease Control (CDC) guidelines and an interview with the administrator, the agency did not provide documentation that a direct care worker (DCW) was screened for and free from active mycobacterium tuberculosis for one (1) of five (5) PF's reviewed: PF#4, and did not provide documentation of completion of a tuberculosis (TB) symptom screen questionnaire and/or TB risk assessment for four (4) of five (5) PF's reviewed: PF#1, 3, 4 & 5
Findings include:
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, HCW's should receive TB screening annually. HCW's 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 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).
A review of PF's was conducted on 12/15/23 starting at approximately 10:15 AM. and revealed the following:
PF#1. Date of Hire: 9/9/23. File did not contain documentation of completion of a tuberculosis (TB) symptom screen questionnaire nor a TB risk assessment upon hire.
PF#3. Date of Hire: 9/4/23. File did not contain documentation of completion of a tuberculosis (TB) symptom screen questionnaire nor a TB risk assessment upon hire.
PF#4. Date of Hire: 5/4/22. File contained documentation of a single step tuberculin skin test (TST) administered on 5/9/22. There was no second step TST contained in the file. There was no documentation of completion of a TB risk assessment completed upon hire.
PF#5. Date of Hire: 9/9/23. File did not contain documentation of completion of a tuberculosis (TB) symptom screen questionnaire nor a TB risk assessment upon hire.
An interview conducted with the administrator on 12/15/23 at approximately 12:45 PM confirmed the above findings.
Plan of Correction:The Agency tuberculosis (TB) symptom screen questionnaire was updated on 12/15/23 to include information from the CDC Health Care Personnel (HCP) Baseline Individual TB Risk Assessment. The four employees identified (PF#1, PF#3, PF#4 and PF#5) will be given the updated questionnaire to complete.
To assure that all employees meet the TB screening requirement, the Agency reviewed the files of all active employees on 12/15/23 to verify that the TB requirements were met. The review findings were consistent with the investigator's findings.
To ensure that the deficient practice does not occur again, the Agency updated both its tuberculosis (TB) symptom screen questionnaire form and the New Hire File Requirements Checklist to include verification of tuberculosis (TB) symptom screen questionnaire with TB risk assessment upon hire.
To monitor ongoing compliance, The Office Manager will perform a quarterly review of new hire files for employees hired within the given quarter. The updated New Hire file Requirements Checklist will be the tool used for this review of the affected files.
The 4 impacted employees will complete the updated tuberculosis (TB) symptom screen questionnaire by February 16, 2024.
Initial Comments:
Based on the findings of an onsite state re-licensure survey conducted on December 15, 2023, 1st Choice Home Health Care-PA, LLC., was found to be in compliance with the requirements of 35 P.S. 448.809 (b).
Plan of Correction:
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