Initial Comments:
Based on the findings of an onsite unannounced home care agency complaint investigation survey completed October 31, 2023., Curantis Home Care, 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:
611.57(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 review of Consumer files,complaint log, Interview with agency administrator, the agency failed to ensure the consumer received services as agreed upon for one (1) of two (2) consumer files (CF # 1 and CR # 2)
Findings include:
1.Review of CR # 1's file on 10/13/23 at approximately 10:15 AM revealed: Start of care (SOC): 5/28/23. CR # 1 had missed shifts as follows:
6/1-no coverage from 8am-4pm
6/2-no coverage from 4pm until 6/3 at 8am
6/8-no coverage from 8am until 12am
6/15- no coverage from 4pm until 12am
6/17- agency provided no hours
6/23 and 6/27 no coverage between 8am-4pm
6/29-no coverage from 8am-12pm
7/3, 5, and 11-no coverage from 8am-4pm
7/12-no coverage from 4 pm-12am
7/13-no coverage from 8 am-4 pm
7/15- no coverage from 8 am-10am then 3pm-4pm
7/17-no coverage from 8am-4pm
8/1-no coverage from 8pm-12am
8/4-no coverage from 4pm-12am
8/12-no coverage from 4pm-12am
8/13-no coverage from 8am-4pm
8/27-no coverage from 8am-4pm
8/31-no coverage from 4pm-7pm
2. Review of CR # 2 on 10/13/23 at approximately 10:25 AM revealed: Start of Care (SOC): 5/19/23 and CR # 2 had no missed shifts.
An interview conducted with the agency administrator on 10/31/23 at approximately 12:05 PM confirmed the above findings. Interview with agency administrator on 10/16/23 at 3:39 PM revealed: " With our current software, we cannot determine when we send in another caregiver in the place of one that may call off or not show up. We just change the name in the schedule where appropriate. As discussed, we may just develop a spread sheet or something if that is necessary. They only way we can typically tell is if there is another caregiver's name in the schedule that is not their normal caregiver, then that would be the substitute for that shift."I don't have any "documentation" of my conversations with clients. I cannot imagine what kind of data base that would require if I were to capture my conversations on a daily basis. "
Plan of Correction:As discussed during our interviews, each one of the dates and scheduled times noted were covered by either family members, friends, other caregivers not yet hired (due to completing background checks), or even myself (the Owner of Curantis). As we discussed, we agreed that documentation is everything because we were not able to record this activity appropriately. So again, we didn't fail to ensure the consumer received services, we just failed to document how he was appropriately covered for the reported shifts. I am certain that the participant (client) can attest that he has never been left alone by our agency.
To that end, as of 10/27/23, our software provider SwyftOps has enabled an excellent "notes and documentation" feature in our profile that will allow us to capture caregiver substitutions, call-offs, shift changes, in addition to the ability to document conversations with the client. We can now annotate discussions regarding billing issues, complaints, refusal of services, and other items relevant to their care. It was unfortunate to have to go through this, but I am actually grateful that our software provider was able to provide us with an expedient reliable solution electronically that we can produce and provide live at any given time. If anyone needs any screenshots or a demo of what these new features can do, please let us know.
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