Initial Comments:
Based on the findings of an offsite unannounced complaint investigation survey completed December 8, 2021, Nation Home Healthcare Services LLC, was found NOT to be in compliance with the following requirements of PA Code, Title 28, Health and Safety, Part IV, Health Facilities, Subpart H, Chapter 611, Home Care Agencies and Home Care Registries.
Plan of Correction:
611.51(a) LICENSURE
Hiring or Rostering Prerequisites
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Prior to hiring or rostering a direct care worker, the home care agency or home care registry shall: (1) Conduct a face-to-face interview with the individual. (2) Obtain not less than two satisfactory references for the individual. A satisfactory reference is a positive, verifiable reference, either verbal or written, from a former employer or other person not related to the individual that affirms the ability of the individual to provide home care services. (3) Require the individual to submit a criminal history report, in accordance with the requirements of § 611.52 (relating to criminal background checks), and a ChildLine verification, if applicable, in accordance with the requirements of § 611.53 (relating to child abuse clearance).
Observations:
Based on review of personnel files, and staff interview, it was determined that the agency failed to complete background checks through the Pennsylvania Access To Criminal History, (PATCH), at the time of application, or immediately preceding the date of application for two, (2), of three, (3), Direct Care Workers, (DCW), reviewed. (DCW # 1, and 2).
Findings include:
On, November 22, 2021, at approximately 12:00 p.m., a review of DCW #1, revealed a date of hire on October 13, 2020. A further review revealed of PF#1 did not have a criminal history report was obtained through PATCH, at time of employment.
On November 22, 2021, at approximately 12:15 p.m., a review of DCW #2, revealed a date of hire on August 13, 2021. A further review revealed PF #2, did not have a criminal history report was obtained through PATCH, at time of employment.
On December 7, 2021, at approximately 2:30 p.m., in an interview with the Administrator it was confirmed that the agency had failed to conduct a criminal history report for two DCW's.
Plan of Correction:The Criminal Background checks for DCW#1 and DCW#2 has been ran. To prevent this happening in the future Administrative Personnel has been brought into the office to focus solely on Patient/Caregiver Compliance.
611.57(a) LICENSURE
Consumer Rights
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(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 review of employee files, times sheets, and interview with the Administrator, it was determined that the agency failed to deliver services with reasonable accommodation of the individual needs and preferences. The agency failed to To provide a 10 calendar days advance written notice of the intent of the home care agency or home care registry to terminate services for one, (1), of three, (3), Consumer Files, (CF), reviewed. (CF #2).
Findings include:
On November 22, 2021, at approximately 10:00 a.m., a review of CF #2, revealed a start of care on August 30, 2021, for 12 hours of care, seven, (7), days a week. A review of a document titled "HHAexchange," calendar of clock-ins, (time sheets), from October 1, 2021 through October 31, 2021 revealed the following:
1.October 2, 2021 Clocked in at 8:00 a.m. and left at approximately 9:30 a.m. (Given a choice to leave after a verbal altercation.)
(1.5 hours.)
2.October 2, 2021-Clocked in at 8:00 a.m. and left at approximately 9:30 a.m. (DCW left to get a gift.)
(1.5 hours.)
3.October 3, 2021-Clocked in at 8:00 a.m. and left at approximately 3:00 p.m.
(7.0 hours.)
4. October 4, 2021-Clocked in at 8:00 a.m. and left at approximately 8:45 a.m.. (A verbal altercation over money, and told to leave.)
(45 minutes.)
On October 2, 2021, and October 4, 2021, the DCW was told to leave.
There was no activity reported to HHAexchage from October 5, 2021 through November 22, 2021.
On November 22, 2021, at 10:55 a.m., an email was sent from this surveyor to the agency, to provide information on the missed visits from October 5, 2021 through November 22, 2021.
On November 23, 2021, at approximately 11:00 a.m., the agency submitted a letter dated October 4, 2021, addressed to the complainant. The letter stated that, "as of October 5, 2021, services will be terminated." The reason for an abrupt termination was cited as the CR #2, did "not like gay men." The reason stated for termination did not meet the exception that for less than 10 days advance written notice may be provided in the event the consumer has failed to pay for servies, is more than 14 days in arrears, or if the health and welfare of the staff member is at risk.
On November 23, 2021, at approximately 3:30 p.m., It was confirmed with the Administrator that services were not provided on the dates above mentioned, and suspended after October 4, 2021 without prior advanced 10 day notice of the agency's intent.
Plan of Correction:Moving forward, if the Agency chooses to terminate providing service to a consumer, a certified letter will be sent to the consumers home along with an email followed by a phone call indicating the termination of services 10 days from notification while still providing services until that that.
Initial Comments:
Based on the findings of an off-site unannounced complaint investigation survey completed, December 8, 2021 Nation Home Healthcare Services LLC, was found not to be in compliance with the following requirement of 35 P.S. 448.809 (b).
Plan of Correction:
35 P. S. § 448.809b LICENSURE
Photo Id Reg
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Law amended July 11, 2022 Act 79 2022 HB 2604
(1) The photo identification tag shall include a recent
photograph of the employee, the employee's first name, the
employee's title and the name of [the health care facility or
employment agency.] any of the following:
(i) The health care facility.
(ii) The health system.
(iii) The employment agency.
(iv) The fictitious name of an entity under
subparagraph (i), (ii) or (iii) which is registered with
the Department of State under 54 Pa.C.S. Ch. 3 (relating
to fictitious names) or a successor statute.
(2) The title of the employee shall be as large as possible
in block type and shall occupy a one-half inch tall strip as
close as practicable to the bottom edge of the badge.
(3) Titles shall be as follows:
(i) A Medical Doctor shall have the title "Physician."
(ii) A Doctor of Osteopathy shall have the title
"Physician."
(iii) A Registered Nurse shall have the title
"Registered Nurse."
(iv) A Licensed Practical Nurse shall have the title
"Licensed Practical Nurse."
(v) All other titles shall be determined by the
department. Abbreviated titles may be used when the title
indicates licensure or certification by a Commonwealth
agency.
(4)A notation, marker or indicator included on an identification badge that differentiates employees with the same first name is considered acceptable in lieu of displaying an employee's last name.
Observations:
Based on documentation provided, and interview with the Agency Administrator, it was determined that the Agency failed to ensure a photo identification tag that would include the employee's full name, title, picture and the name of the agency for all employees.
Findings include:
On December 7, 2021, at approximately 2:30 p.m., a telephone call was made to the agency. The agency was asked to provide proof that they had provided Badges to all employees.
On December 8, 2021, by approximately 10:30 a.m., Documentation was provided from the agency to confirm that badges had been distributed to the DCW's on November 18, 2021. (after complaint date for October 10, 2021.)
In an interview on December 7, 2021 at approximately 2:30 p.m., the Agency Administrator confirmed that photo identification tags were not being worn by the DCW (direct care worker).
Plan of Correction:The Agency now processes Photo Identification tags during a new caregivers onboarding process. Agency's new policy for onboarding goes as follows:
Onboarding must be completed within 72 hrs of caregivers start date to insure photo id badge has been processed and given to caregiver prior to caring for patient.
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