Initial Comments:
Based on the findings of an offsite Complaint Investigation Survey completed 1/19/2024, Always Here Home Care, LLC was found to be in compliance with the requirements of PA Code, Title 28, Health and Safety, Part IV, Health Facilities, Subpart A, Chapter 51.
Plan of Correction:
Initial Comments:
Based on the findings of an offsite Complaint Investigation Survey completed 1/19/2024, Always Here Home Care, LLC was found not to be in compliance with the following requirement(s) 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:
611.56(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 review of direct care worker personnel files (PF), and staff (EMP) interview, the agency failed to ensure a direct care worker, prior to consumer contact, was screened for and free from mycobacterium tuberculosis (TB) for three (3) of eleven (11) direct care worker personnel files reviewed (PF1, PF5 & PF10).
Findings included:
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, HCWs should receive TB screening annually. HCWs 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 the 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).
Review of direct care worker personnel files was conducted on 1/19/2024 between 12:30 p.m. and 4:00 p.m.
PF1 was hired on 11/21/2023 and began providing services to consumers on 11/29/2023. PF did not contain any documentation to prove that PF was screened for and free from TB prior to consumer contact.
PF5 was hired on 11/21/2023 and began providing services to consumers on 12/22/2023. PF did not contain any documentation to prove that PF was screened for and free from TB prior to consumer contact.
PF10 was hired on 12/04/2023 and began providing services to consumers on 12/12/2023. PF did not contain any documentation to prove that PF was screened for and free from TB prior to consumer contact.
Interview with Agency Owner on 1/29/2024 at approximately 2:00 p.m. confirmed the above findings.
Plan of Correction:Always Here Home Care LLC has created a checklist to prompt the hiring manager to require all new hires to complete the PPD Testing and the hiring manager will review each PPD test form to ensure that the forms are completed in it's entirety to include the date of the PPD reading and results.
Always Here Home Care LLC will establish a systematic process to review and verify documentation for each direct care worker and office staff with direct consumer contact. This will include screening for active mycobacterium tuberculosis in accordance with CDC guidelines. The agency will maintain a record of the screening dates, ensuring they are within the required timeframe.
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