QA Investigation Results

Pennsylvania Department of Health
ADA MAE IN HOME CARE AGENCY LLC
Health Inspection Results
ADA MAE IN HOME CARE AGENCY LLC
Health Inspection Results For:

This is the only survey for this facility

Surveys don't appear on this website until at least 41 days have elapsed since the exit date of the survey.



Initial Comments:

Based on the findings of an onsite unannounced state license survey completed August 4, 2022, Ada Mae In Home Care Agency 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 onsite unannounced state license survey completed August 4, 2022, Ada Mae In Home Care Agency 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:




611.4(a) LICENSURE
Requirements for HCA and HCR

Name - Component - 00
A current copy of this Chapter shall be maintained at the home care agency or home care registry.

Observations:


Based on staff (EMP) interview, the agency failed to maintain a current copy of this Chapter.

Findings included:

During a review of Chapter 611 and its requirements with EMP1 on August 3, 2022, at 10:30 a.m. it was learned that EMP1 was not familiar with Chapter 611. At 10:32 a.m., EMP1 searched the office and was unable to locate or access a current copy of Chapter 611.







Plan of Correction:

The following correction has been made. Ada Mae in Home Care Agency LLC will keep a current copy of chapter 611 Title 28. Health and safety Part IV. Health Facilities Subpart H. Home Care Agency And Home Care Registries Chapter 611. Home Care Agencies and Home Care Registries General, this will be available upon request



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 direct care worker personnel files (PF), and staff (EMP) interview, the agency failed to, prior to hire, conduct interviews, obtain two satisfactory references, and initiate criminal history reports in accordance with 611.52 (State Police criminal history record) for five (5) of five (5) personnel files reviewed (PF1-PF5).

Findings included:

Review of personnel files was conducted on August 3, 2022, at 9:45 a.m.

PF1 was hired on 6/7/2021 but the criminal history report was not initiated until 6/30/2021 (late and not prior to hire). PF1 contained no interview and no references.

PF2 was hired on 3/17/2022 and contained no interview and no references.

PF3 was hired on 6/18/2021 but the criminal history report was not initiated until 6/30/2021. PF3 contained no interview and no references.

PF4 was hired on 2/7/2022. PF4 contained no criminal history report, no interview, and no references.

PF5 was hired on 9/24/2021 and contained no interview and no references.

Interview with EMP1 on August 3, 2022, confirmed above findings.














Plan of Correction:

The following corrections have been made. Ada Mae In Home Care Agency LLC general rule. Ada Mae In Care Agency LLC shall require each applicant for employment or referral as a direct care worker to submit a criminal history report obtained at the time of application or within 1 year immediately preceding the date of application. An applicant for employment as a member of the office staff for Ada Mae In Home Care Agency LLC also are required to obtain a criminal history report in accordance with requirements.
State Police criminal history record. Ada Mae In Home Care Agency LLC is required to submit or obtain a criminal history report has been a resident of this Commonwealth for 2 years preceding the date of the request for a criminal history report, the Ada Mae In Home Care Agency LLC shall request a State Police criminal history record. Federal criminal history record. Ada Mae In Home Care Agency LLC is required to submit or obtain a criminal history report has not been a resident of this Commonwealth for the 2 years immediately preceding the date of the request for a criminal history report, the individual shall obtain a Federal criminal history record and a letter of determination from the Department of Aging, based on the individual's Federal criminal history record, in accordance with(relating to procedure).
Proof of residency. Ada Mae In Home Care Agency LLC shall request an individual required to submit or obtain a criminal history record to furnish proof of residency through submission of any one of the following documents:
(1) Motor vehicle records, such as a valid driver's license or a State-issued identification.
(2) Housing records, such as mortgage records or rent receipts.
(3) Public utility records and receipts, such as electric bills.
(4) Local tax records.
(5) A completed and signed, Federal, State, or local income tax return with the applicant's name and address preprinted on it.
Employment records, including records of unemployment compensation.
Ada Mae In Home Care Agency LLC correct plan has been updated. The Compliance Manager & the owner will be monitoring all direct care workers files by looking at each direct care file by looking at our currently direct care workers that are on the schedule the information that will be on the hiring process form will include the application date the date the clearances were done when we this will be on on our hiring Process form that will be in each direct care worker file and it also be available on spread sheet that will be available upon request. The audit for each direct care work will start 09-1-22. We have the information we will have all new direct care worker information to comply before direct car worker is place on the schedule or come in contact with a consumer they will have criminal history report and three references that satisfactory we will make sure everyone comply with 611.52



611.52(a) LICENSURE
Criminal Background Checks

Name - Component - 00
The home care agency or home care registry shall require each applicant for employment or referral as a direct care worker to submit a criminal history report obtained at the time of application or within 1 year immediately preceding the date of application.

Observations:


Based on review of direct care worker personnel files (PF), and staff (EMP) interview, the agency failed to obtain a State Police criminal history record for three (3) of five (5) personnel files reviewed (PF1, PF3, & PF4).

Findings included:

Review of direct care worker personnel files was conducted on August 3, 2022, at 9:45 a.m.

PF1 was hired on 6/7/2021 but the criminal history report was not initiated until 6/30/2021 (late and not prior to hire).

PF3 was hired on 6/18/2021 but the criminal history report was not initiated until 6/30/2021.

PF4 was hired on 2/7/2022 and contained no criminal history report.

Interview with EMP1 on August 3, 2022, confirmed above findings.






Plan of Correction:

The following corrections has been made.
Ada Mae In Home Care Agency LLC shall maintain files for direct care workers and members of the office staff which include copies of State Police criminal history records or Department of Aging letters of determination regarding Federal criminal history records. The files shall be available for Department inspection. Ada Mae In Home Care Agency LLC shall maintain copies of the criminal history report for the agency or registry owners, which shall be available for Department inspection.
Confidentiality. Records maintained. Ada Mae In Home Care Agency LLC shall maintain files for direct care workers and members of the office staff which include copies of State Police criminal history records or Department of Aging letters of determination regarding Federal criminal history records. The files shall be available for Department inspection. The agency or registry shall maintain copies of the criminal history report for the agency or registry owners, which shall be available for Department inspection.
Confidentiality. Ada Mae In Home Care Agency LLC shall keep the information obtained from State Police criminal history records and Department of Aging letters of determination regarding Federal criminal history records confidential and use it solely to determine an applicant's eligibility to be hired, rostered or retained.
Opportunity to appeal. If the decision not to hire, roster or retain an individual is based in whole or in part on State Police criminal history records, Department of Aging letters of determination regarding Federal criminal history records, or both, Ada Mae In Home Care Agency LLC shall provide an affected individual with information on how to appeal to the sources of Exceptions. A direct care worker who has complied with this section and who transfers to another agency or registry owned an operated by same entity is not required to obtain another criminal history report. A direct care worker employed or rostered by an entity that undergoes a change of ownership is not required to obtain another criminal history report to submit to the new owner.
Individuals currently employed or rostered. A direct care worker and each member of the Ada Mae In Home Care Agency LLC office staff who is employed by or rostered by a Ada Mae In Home Care Agency LLC as of December 12, 2009, shall obtain and submit a State Police criminal history record or Department of Aging letter of determination, as applicable, to the Ada Mae In Home Care Agency LLC by April 12, 2010. This subsection does not apply if the Ada Mae In Home Care Agency LLC obtained a criminal history report meeting the requirements of this subsection when the direct care worker or office staff member was hired or rostered and a copy of the report is included in the individual's file.

Ada Mae In Home Care Agency LLC shall keep the information obtained from State Police criminal history records and Department of Aging letters of determination regarding Federal criminal history records confidential and use it solely to determine an applicant's eligibility to be hired, rostered or retained.
(h)Opportunity to appeal. If the decision not to hire, roster or retain an individual is based in whole or in part on State Police criminal history records, Department of Aging letters of determination regarding Federal criminal history records, or both, Ada Mae In Home Care Agency LLC shall provide an affected individual with information on how to appeal to the sources of criminal history records if the individual believes the records are in error.
Exceptions. A direct care worker who has complied with this section and who transfers to another agency or registry owned and operated by same entity is not required to obtain another criminal history report. A direct care worker employed or rostered by Ada Mae In Home Care Agency LLC by an entity that undergoes a change of ownership is not required to obtain another criminal history report to submit to the new owner.
Individuals currently employed or rostered. A direct care worker and each member of the agency or registry office staff who is employed by or rostered by a Ada Mae In Home Care Agency LLC registry as of December 12, 2009, shall obtain and submit a State Police criminal history record or Department of Aging letter of determination, as applicable, to the home care agency or home care registry by April 12, 2010. This subsection does not apply if the Ada Mae In Home Care Agency LLC obtained a criminal history report meeting the requirements of this subsection when the direct care worker or office staff member was hired or rostered and a copy of the report is included in the individual's file.

Ada Mae In Home Care Agency LLC registry shall maintain files for direct care workers and members of the office staff which include copies of State Police criminal history records or Department of Aging letters of determination regarding Federal criminal history records. The files shall be available for Department inspection. Ada Mae In Home Care Agency LLC shall maintain copies of the criminal history report for the agency or registry owners, which shall be available for Department inspection.
Confidentiality. Ada Mae In Home Care Agency LLC shall keep the information obtained from State Police criminal history records and Department of Aging letters of determination regarding Federal criminal history records confidential and use it solely to determine an applicant's eligibility to be hired, rostered or retained.
Opportunity to appeal. If the decision not to hire, roster or retain an individual is based in whole or in part on State Police criminal history records, Department of Aging letters of determination regarding Federal criminal history records, or both, the Ada Mae In Home Care Agency LLC shall provide an affected individual with information on how to appeal to the sources of criminal history records if the individual believes the records are in error.
Exceptions. A direct care worker who has complied with this and who transfers to another agency or registry owned and operated by same entity is not required to obtain another criminal history report. A direct care worker employed or rostered by an entity that undergoes a change of ownership is not required to obtain another criminal history report to submit to the new owner.
Individuals currently employed or rostered. A direct care worker and each member of the Ada Mae In Home Care Agency LLC office staff who is employed by or rostered by a Ada Mae In Home Care Agency LLC as of December 12, 2009, shall obtain and submit a State Police criminal history record or Department of Aging letter of determination, as applicable, to Ada Mae In Home Care Agency LLC by April 12, 2010. This subsection does not apply if the home care agency or home care registry obtained a criminal history report meeting the requirements of this subsection when the direct care worker or office staff member was hired or rostered and a copy of the report is included in the individual's file. To make sure we have everything we have a hiring process has t be completed before a direct care worker can go on the schedule or have contact with consumer.

This will be monitor on monthly basic by Compliance manager and Owner. We will monitor this by doing an audit starting 9-1-2022. We make sure all direct care worker and current office staff file will comply by using our hiring process form also have a spread sheet with all information that comply we will have the police criminal report after face to face interview


611.52(d) LICENSURE
Proof of Residency

Name - Component - 00
The home care agency or home care registry may request an individual required to submit or obtain a criminal history record to furnish proof of residency through submission of any one of the following documents:
(1) Motor vehicle records, such as a valid driver ' s license or a State-issued identification.
(2) Housing records, such as mortgage records or rent receipts.
(3) Public utility records and receipts, such as electric bills.
(4) Local tax records.
(5) A completed and signed, Federal, State or local income tax return with the applicant ' s name and address preprinted on it.
(6) Employment records, including records of unemployment compensation

Observations:


Based on review of direct care worker personnel files (PF), and staff (EMP) interview, the agency failed to ensure three (3) of five (5) personnel files contained proof of residency (PF1, PF3, & PF5).

Findings included:

Review of personnel files was conducted on August 3, 2022, at 9:45 a.m.

PF1 was hired on 6/7/2021. PF1 contained a PA driver's license but the license was issued on 4/24/2020 (not 2 years preceding the date of hire). PF1 contained no other documentation to show this requirement was met.

PF3 was hired on 6/18/2021. PF3 contained a PA driver's license but the license was issued on 11/20/2020. PF3 contained no other documentation to show this requirement was met.

PF5 was hired on 9/24/2021. PF5 contained no documentation to show this requirement was met.

Interview with EMP1 on August 3, 2022, confirmed above findings.







Plan of Correction:

Hiring or rostering prerequisites.
Prior to being hiring by Ada Mae In Home Care Agency LLC, a face-to-face interview with the individual will be conducted.
Ada Mae In Home Care Agency LLC will obtain at least three 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.
Ada Mae In Home Care Agency LLC is require to have individual to submit a criminal history report, in accordance with §  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).

Direct care worker files. Ada Mae In Home Care Agency LLC Files for direct care workers employed or rostered by Ada Mae In Home Care Agency LLC shall include documentation of the date of the face-to-face interview with the individual and of references obtained. Direct care worker files must also include other information as required under §  611.52, §  611.53, and if applicable, § §  611.54, 611.55 and 611.56 (relating to provisional hiring; competency requirements; and health screening).
Ada Mae In Home Care Agency LLC will be monitor by the compliance manager and owner using our new created hiring process form that will show the date of the competency test and all new direct worker will need to provide driver license and that will have 2 year proof of residency that will also be on a spread sheet upon request, on the hiring process form and the audit to check current direct care worker start 9-1-2022 to comply 611.54 611.55


611.55(a) LICENSURE
Compentency Requirements

Name - Component - 00
Prior to assigning or referring a direct care worker to provide services to a consumer, the home care agency or home care registry shall ensure that the direct care worker has done one of the following: (1) Obtained a valid nurse ' s license in this Commonwealth;
(2) Demonstrated competency by passing a competency examination developed by the home care agency or home care registry which meets the requirements of subsection (b)and (c).
(3) Has successfully completed one of the following:
(i) A training program developed by a home care agency, home care registry, or other entity which meets the requirements of subsection (b) and (c).
(ii) A home health aide training program meeting the requirements of 42 C.F.R. 484.36 (relating to the Conditions of Participation; Home Health Aide Services).
(iii) The nurse aid certification and training program sponsored by the Department of Education and located at www.pde.state.pa.us.
(iv) A training program meeting the training standards imposed on the agency or registry by virtue of the agency ' s or registry ' s participation as a provider in a Medicaid waiver or other publicly funded program providing home and community based services to qualifying consumers.
(v) Another program identified by the Department by subsequent publication in the Pennsylvania Bulletin or on the Department ' s website.

Observations:

Based on review of personnel files (PF), and staff (EMP) interview, the agency failed to ensure the direct care worker (DCW) had successfully completed a training program that met the requirements of subsection (b) and (c) prior to being assigned to a consumer for four (4) of five (5) personnel files reviewed (PF1-PF4).

Findings included:

Review of personnel files was conducted on August 3, 2022, at 9:45 a.m.

PF1 was hired on 6/7/2021 and began working with consumers on 6/27/2021. PF1 contained a certificate for a training program titled "ADULT RESIDENTIAL LICENSING ... Direct Care Staff Training Course" prior to consumer contact, but the training course did not include the required subjects of: Confidentiality; Consumer control and the independent living philosophy; Recognizing changes in the consumer that need to be addressed; Shaving and mouth care; Assistance with ambulation and transferring; Feeding; Toileting; and Assistance with self-administered medications.

PF2 was hired on 3/17/2022 and began working with consumers on 3/31/2022. PF2 contained no evidence of competency prior to consumer contact.

PF3 was hired on 6/18/2021 and began working with consumers on 6/19/2021. PF3 contained no evidence of competency prior to consumer contact.

PF4 was hired on 2/7/2022 and began working with consumers on 2/27/2022. PF4 contained no evidence of competency prior to consumer contact.

Interview with EMP1 on August 3, 2022, confirmed above findings. EMP1 noted he/she could not locate the training certificates for PF2-PF4 at time of onsite survey. But that PF2-PF4 would have completed the same competency program as PF1 and would have received a similar certificate. EMP1 said he/she would email certificates to surveyor. Surveyor requested documentation be submitted via email by 12 p.m. on August 4, 2022. Review of email on August 4, 2022, at 12 p.m. showed that EMP1 emailed generic training certificates for PF3 & PF4, "Certificate of Completion ... This Certificate is Dedicated to [direct care worker] For completing Ada Mae In-Home Care Agency Competency Test." There was nothing to show what the content of the training was and or if it covered all necessary subjects. EMP1 emailed nothing to show PF2 met minimum competency requirements.











Plan of Correction:

Prior to assigning a direct care worker to provide services to a consumer, Ada Mae In Home Care Agency LLC shall ensure that the direct care worker has done one of the following:
   Obtained a valid nurse's license in this Commonwealth.
     Demonstrated competency by passing a competency examination developed by the home care agency or home care registry which meets the requirements of subsections (b) and (c).
     Successfully completed one of the following:
      A training program developed by Ada Mae In Home Care Agency LLC or other entity which meets the requirements of subsections and        A home health aide training program meeting the requirements of 42 CFR 484.36 (relating to the conditions of participation; home health aide services).
     The nurse aid certification and training program sponsored by the Department of Education and located at www.pde.state.pa.us. Direct Care worker Will Use Ada Mae In Home Care Competency Test.
       A training program meeting the training standards imposed on the agency or registry by virtue of the agency's or registry's participation as a provider in a Medicaid Waiver or other publicly funded program providing home and community based services to qualifying consumers.
       Another program identified by the Department by subsequent publication in the Pennsylvania Bulletin or on the Department's web site.
  A competency examination or training program developed by Ada Mae In Home Care Agency LLC for a direct care worker must address, at a minimum, the following subject areas:
   (1)  Confidentiality.
   (2)  Consumer control and the independent living philosophy.
   (3)  Instrumental activities of daily living.
   (4)  Recognizing changes in the consumer that need to be addressed.
   (5)  Basic infection control.
   (6)  Universal precautions.
   (7)  Handling of emergencies.
   (8)  Documentation.
   (9)  Recognizing and reporting abuse or neglect.
   (10)  Dealing with difficult behaviors.
 (c)  A competency examination or training program developed by Ada Mae IN Home Care Agency LLC for a direct care worker who will provide personal care must address the following additional subject areas:
   (1)  Bathing, shaving, grooming and dressing.
   (2)  Hair, skin and mouth care.
   (3)  Assistance with ambulation and transferring.
   (4)  Meal preparation and feeding.
   (5)  Toileting.
   (6)  Assistance with self-administered medications.
 (d)  Ada Mae In Home Care Agency LLC shall include documentation of the direct care worker's satisfactory completion of competency requirements in the direct care worker's file. If the direct care worker has a nurse's license or other licensure or certification as a health professional, the individual's file shall include a copy of the current license or certification. Documentation of satisfactory completion of competency requirements is transferable from one home care agency or registry to another home care agency or registry, provided the break in the individual's employment or roster status does not exceed 12 months.
 (e)  Ada Mae In Home Care Agency LLC also shall include documentation in the direct care worker's file that the Ada Mae In Home Care Agency LLC has reviewed the individual's competency to perform assigned duties through direct observation, testing, training, consumer feedback or other method approved by the Department or through a combination of methods. The competency review must occur at least once per year after initial competency is established, and more frequently when discipline or other sanction, including, for example, a verbal warning or suspension, is imposed because of a quality of care infraction.
  A direct care worker employed by Ada Mae In Home Care Agency LLC on December 12, 2009, shall achieve compliance with the competency requirements imposed by this chapter by December 12, 2011.
Ada Mae In Home Care Agency will monitored this by having this information on the New hiring process form and also put on a spread we also started the audit 9-1-2022 to corrected this will be monitored by Owner and compliance manager this also will be completed doing the face to face interview.So it completed in a timely manner


611.56(a) LICENSURE
Health Screening

Name - Component - 00
The screening shall be conducted in accordance with CDC guidelines for preventing the transmission of mycobacterium tuberculosis in health care settings. The documentation must indicate the date of the screening which may not be more than 1 year prior to the individual's start date.

Observations:


Based on a review of CDC (Center for Disease Control and Prevention) guidelines, direct care worker personnel files, and staff (EMP) interview, the agency failed to ensure each direct care worker was screened for free from active mycobacterium tuberculosis (TB) in accordance with CDC (Center for Disease and Control) guidelines prior to consumer contact for five (5) of five (5) personnel files (PF1-PF5).

Findings included:

According to the "Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in Health-Care Settings, 2005," "Baseline testing for M. Tuberculosis infection is recommended for all newly hired HCWs [health care workers] ... If TST [tuberculin skin testing] is used for baseline testing, two-step testing is recommended for HCWs whose initial TST results are negative ... A second TST is not needed if the HCW has a documented TST result from any time during the previous 12 months. If a newly employed HCW has had a documented negative TST result within the previous 12 months, a single TST can be administered in the new setting ... This additional TST represents the second stage of the two-step testing." Retrieved from 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 personnel files was conducted on August 3, 2022, at 9:45 a.m.

PF1 was hired on 6/7/2021 and began working with consumers on 6/27/2021. PF2 contained no TB symptom screen, no individual risk assessment, and no annual TB education.

PF2 was hired on 3/17/2022 and began working with consumers on 3/31/2022. PF2 contained a TB skin test that was completed over 12 months ago. PF2 then received a single step TB test on 4/21/2022 (after already in contact with consumers and no second step completed). PF2 contained no symptom screen, and no individual risk assessment.

PF3 was hired on 6/18/2021 and began working with consumers on 6/19/2021. PF3 contained no two-step TB test, no symptom screen, no individual risk assessment, and no annual TB education.

PF4 was hired on 2/7/2022 and began working with consumers on 2/27/2022. PF4 contained a TB skin test that was completed over 12 months ago with no further testing completed. PF4 contained no recent two-step TB test, no symptom screen, and no individual risk assessment.

PF5 was hired on 9/24/2021 and began working with consumers on 9/26/2021. PF4 contained no two-step TB test, no symptom screen, and no individual risk assessment.

Interview with EMP1 on August 3, 2022, confirmed above findings, and he/she noted that it is agency policy that direct care workers receive a two-step TB skin test.











Plan of Correction:

Ada Mae In Home Care Agency LLC 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. The screening shall be conducted in accordance with CDC guidelines for preventing the transmission of mycobacterium tuberculosis in health care settings. The documentation must indicate the date of the screening which may not be more than 1 year prior to the individual's start date.
 Ada Mae In Home Care Agency LLC shall require each direct care worker, and other office staff or contractors with direct consumer contact, to update the documentation required under subsection (a) at least every 12 months and provide the documentation to the agency or registry. The 12 months must run from the date of the last evaluation. The documentation required under subsection (a) shall be included in the individual's file.
A direct care worker employed by Ada Mae In Home Care Agency LLC on December 12, 2009, shall achieve compliance with the health evaluation requirements imposed by this chapter by June 10, 2010.
This will be monitored with our new hiring process form and also done on a spread sheet and where you see when the screen was done and the result place in the direct care worker file and it will be available at anytime to review when After the TB has expire each direct care worker that is employed by Ada Mae In Home Care Agency LLC will be educated on Tb screen and receive a certificate that they completed the training and the audit was started 9-1-2022 to make sure all workers are in comply.



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 review of consumer files (CF), agency information packet, and staff (EMP) interview, the agency failed to provide the consumer with required information in a format that was easily read and understood prior to commencement of services for six (6) of six (6) consumer files reviewed (CF1-CF6).

Findings included:

Review of consumer files was conducted on August 3, 2022, at 11 a.m.

CF1 signed their service agreement on 5/12/2022 and services commenced on 5/16/2022.

CF2 signed their service agreement on 1/27/2022 and services commenced on 1/28/2022.

CF3 signed their service agreement on 5/4/2022 and services commenced on 5/6/2022.

CF4 signed their service agreement on 6/6/2022 and services commenced on 6/10/2022.

CF5 signed their service agreement on 2/24/2022 and services commenced on 2/25/2022.

CF6 signed their service agreement on 6/9/2022 and services commenced on 6/9/2022.

The service agreements for CF1-CF6 did not contain a listing of the available home care services that would be provided to the consumer by the direct care worker and the identity of the direct care worker who would provide the services; the hours when those services will be provided; or 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.

Additionally, a review agency information packet provided to consumers prior to start of services did not show it contained information on 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 nor the Department's complaint Hot Line (1-800-254-5164).

Interview with EMP1 on August 3, 2022, at 12 p.m. confirmed above findings.










Plan of Correction:

 (a)  Consumer rights. The consumer of Ada Mae In Home Care Agency LLC provided by a home care agency or through a home care registry 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.
   (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.
 (b)  Prohibitions. No individual as a result of the individual's affiliation with Ada Mae In Home Care Agency LLC may assume power of attorney or guardianship over a consumer utilizing the services of that home care agency or home care registry. Ada Mae In Home Care Agency LLC may not require a consumer to endorse checks over to the Ada Mae In Home Care Agency LLC.
 (c)  Information to be provided. Prior to the commencement of services, the Ada Mae In Home Care Agency LLC 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 (1-866-826-3644) 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.
 (d)  Documentation. The Ada Mae In Home Care Agency LLC shall maintain documentation on file at the agency or registry of compliance with the requirements of this section which shall be available for Department inspection.

Ada Mae In Home Care Agency LLC has updated the correct information to all consumers, this will be monitor when we do the intake with the consumer and this also will be monitored monthly by audit starting 9-1-22 and this will be on our new client process form the monitor by compliance manager & owner and current client have received updated packets with the correct information



Initial Comments:


Based on the findings of an onsite unannounced state license survey completed August 4, 2022, Ada Mae In Home Care Agency Llc was found to be in compliance with the requirement of 35 P.S. 448.809 (b).




Plan of Correction: