Initial Comments:
Based on the findings of an off-site unannounced follow-up survey completed 11/13/2023, Independence At Home Llc 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 State relicensure survey completed 5/9/2022.
Plan of Correction:
611.51(a) LICENSURE
Hiring or Rostering Prerequisites
Name - Component - 00
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 agency documents and personnel files (PF), and staff (EMP) interview, it was determined the agency failed to obtain 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 for two (2) of four (4) direct care worker (DCW) PFs reviewed (PF2 and PF3).
Findings included:
Focused review of the personal file documents on 11/2/2023 at approximately 10:12 AM revealed, Document " Reference and Interview, Applicant Name: Date of Interview: Interview Type: In Person, Or virtual, Name of Reference: Phone Number: Date: Positive Reference Provided: Name of Reference: Phone Number: Date: Positive Reference Provided:
Reference check provided by: "
Review of PF#2, date of hire (DOH) 4/18/2022, was conducted on 11/2/2023 at approximately 12:05 PM. The PF contained evidence of the agency completing two (2) references on 4/11/2022. The agency references could not confirm that the source was from a former employer or other person not related to the individual that could affirm the ability of the individual to provide home care services.
Review of PF#3, date of hire (DOH) 10/16/2023, was conducted on 11/2/2023 at approximately 12:15 PM. The PF contained evidence of the agency completing two (2) references on 10/13/2023. The agency references could not confirm that the source was from a former employer or other person not related to the individual that could affirm the ability of the individual to provide home care services.
An exit interview was conducted with the client coordinator and office manager on 11/2/2023 at approximately 1:00 PM which confirmed the above findings.
Plan of Correction:Office staff will conduct face to face interviews with all new hires. During the interview process office staff will obtain 2 satisfactory references from a former employer and/or another person not related to the individual that affirms the ability of the individual to provide home care services.
Office staff will label both references as professional and personal. If no professional reference is provided office staff will document, it in the new hire's folder.
All current employee files will be checked to make sure appropriate references are present.
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:
Based on a review of the agency policy, consumer records (CR) and staff (EMP) interview, the agency failed to involve the consumer in the service planning process and to receive services with reasonable accommodation of individual needs and preferences for one (1) of four (4) CR's reviewed (CR1).
Findings included:
Focused review of the agency policy on 11/2/2023 at approximately 10:15 AM revealed,"Consumer Rights...2) Consumer Rights, The consumer of home care services provided by (Agency). Shall have the following rights: 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..."
A review of CR1 on 11/2/2023 at approximately 11:15 AM was conducted, the consumer ' s start of services was 10/9/2023. The consumer "SERVICE AGREEMENT CONTRACT" or any other documentation within the consumer file was not signed by the consumer or consumer representative. No information was available to confirm if services were provided per agreement between the consumer and agency upon review.
An exit interview was conducted with the client coordinator and office manager on 11/2/2023 at approximately 1:00 PM which confirmed the above findings.
Plan of Correction:The agency's Client coordinator is assigned to complete all home visits prior to the start of service with the consumer. Client coordinator will review all appropriate documents with consumers and/or the consumer's representee. All consumers or consumer's representee will sign appropriate documents. All consumers have the right 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.
611.57(c) LICENSURE
Information to be Provided
Name - Component - 00
(c) Prior to the commencement of services, the home care agency or home care registry shall provide to the consumer, the consumer's legal representative or responsible family member an information packet containing the following information in a form that is easily read and understood: (1) A listing of the available home care services that will be provided to the consumer by the direct care worker and the identity of the direct care worker who will provide the services. (2) The hours when those services will be provided. (3) Fees and total costs for those services on an hourly or weekly basis. (4) Who to contact at the Department for information about licensure requirements for a home care agency or home care registry and for compliance information about a particular home care agency or home care registry. (5) The Department's complaint Hot Line (1-800-254-5164) and the telephone number of the Ombudsman Program located with the local Area Agency on Aging (AAA). (6) The hiring and competency requirements applicable to direct care workers employed by the home care agency or referred by the home care registry. (7) A disclosure, in a format to be published by the Department in the Pennsylvania Bulletin by February 10, 2010, addressing the employee or independent contractor status of the direct care worker providing services to the consumer, and the resultant respective tax and insurance obligations and other responsibilities of the consumer and the home care agency or home care registry.
Observations:
Based on a review of consumer records (CR) and staff interview, the agency failed to provide required information in writing to consumers/consumer representatives prior to the commencement of services for one (1) of four (4) CRs reviewed (CR1).
Findings included:
Focused review of the agency policy on 11/2/2023 at approximately 10:15 AM revealed, "Consumer Rights...Information to be provided. Prior to the commencement of services, (Agency) shall provide to the consumer, the consumer ' s legal representative or responsible family member and information packet containing the following information in a form that is easily read and understood: a. A listing of the available home care services that will be provided to the consumer by the direct care worker and the identity of the direct care worker who will provide the services. b. The hours when those services will be provided. c. Fees and total cost for those services on an hourly or weekly basis..."
A review of CR1 on 11/2/2023 at approximately 11:15 AM was conducted, the consumer's start of services was 10/9/2023.
No documentation was made available to confirm the consumer/consumer representative was provided an information packet containing the following:
1. The services to be provided and the identity of the direct care worker who would provide services.
2. The hours when services would be provided.
3. The fees and total costs for services.
4. Who to contact at the Department of Health for information about regulations and/or home care agency/registry compliance.
5. The Department of Health's complaint hotline.
6. The local Area Agency on Aging's Ombudsman Program telephone number.
7. The hiring and competency requirements of direct care workers.
8. The consumer disclosure notice regarding employee or independent contractor status of direct care workers and the resultant tax and insurance obligations and other responsibilities.
An exit interview was conducted with the client coordinator and office manager on 11/2/2023 at approximately 1:00 PM which confirmed the above findings.
Plan of Correction:The agency's Client coordinator is assigned to complete all home visits prior to the start of service with the consumer. Client coordinator will review all appropriate documents with consumers and/or the consumer's representee. All consumers or consumer's representee will sign appropriate documents. All consumers have the right 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.
Prior to the commencement of service, the client coordinator will provide to the consumer, the consumer's legal representative or responsible family member an information packet containing the following information in a form that is easily read and understood:
a. A listing of the available home care services that will be provided to the consumer by the direct care worker and the identity of the direct care worker who will provide the services.
b. The hours when those services will be provided.
c. Fees and total cost for those services on an hourly or weekly basis.
d. Who to contact at the Department of Health for information about regulations and/or home care agency/registry compliance.
e. The Department of Health's complaint hotline.
f. The local Area Agency on Aging's Ombudsman Program telephone number.
g. The hiring and competency requirements of direct care workers.
h. The consumer disclosure notices regarding employee or independent contractor status of direct care workers and the resultant tax and insurance obligations and other responsibilities.
|