QA Investigation Results

Pennsylvania Department of Health
APLUS UNITED HOME CARE, LLC
Health Inspection Results
APLUS UNITED HOME CARE, 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 re-licensure survey conducted on April 9, 2024, APlus United 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 onsite unannounced state re-licensure survey conducted on April 9, 2024, APlus United Home Care, LLC, was found not to be in compliance with the requirements of 28 Pa. Code, Part IV, Subpart H, Chapter 611, Home Care Agencies and Home Care Registries.





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 personnel files (PF) and employee (EMP) interview the agency failed to obtain two satisfactory references prior to hiring a direct care worker for two (2) of five (5) PFs reviewed (PF1 & 4).

Findings included:

Review of PFs conducted on April 9, 2024, between approximately 10:30am and 11:30am revealed:

PF1, date of hire (DOH)11/30/23, start of services (SOS) 11/30/23, failed to include evidence of two satisfactory references.

PF4, DOH 3/7/23, SOS 3/7/23, failed to include evidence of two satisfactory references.

Findings confirmed at exit interview with Manager, Human Resources, Intake Coordinator, Office Coordinator, and Staffing Coordinator on April 9, 2024, at approximately 2:30pm.










Plan of Correction:

The Agency failed to include evidence of two satisfactory references. This deficiency has been corrected and is now met. The Agency Manager has re-educated Hr manager, And Hr department regarding conducting and adherence to requirement. PF1 and PF4 files have been corrected and are now in compliance with standard, the completion date will be 05/24/2024.

The HR manager is responsible for implementing this correction. The Hr manager must assure us that obtain not less than two satisfactory references. The HR manager will review all personnel files before hiring and monthly until there is 100% compliance. Then they will be reviewed quarterly for one year. Thereafter all personnel files will be reviewed upon hire, at 90 days, whenever there is a change in the policy, and at the time of performance evaluation. This process will continue an on-going basis to ensure compliance.



611.55(e) LICENSURE
Competency Requirements

Name - Component - 00
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.

Observations:


Based on review of personnel files (PF) and employee (EMP) interview the agency failed to ensure competency review occurred at least once per year after initial competency was established, for three (3) of three (3) PFs reviewed having employment for greater than 12 months (PF2, 4, & 5).

Findings included:

Review of PFs conducted on April 9, 2024, between approximately 10:30am and 11:30am revealed:

PF2, date of hire (DOH) 1/10/23, start of services (SOS) 1/10/23, failed to include evidence of annual competency established for 2024. Initial competency dated 1/10/23.

PF4, DOH 3/7/23, SOS 3/7/23, failed to include evidence of annual competency established for 2024. Initial competency dated 3/6/23.

PF5, DOH 7/21/22, SOS 7/21/22, failed to include evidence of annual competency established for 2023. Initial competency dated 7/20/22.

Findings confirmed at exit interview with Manager, Human Resources, Intake Coordinator, Office Coordinator, and Staffing Coordinator on April 9, 2024, at approximately 2:30pm.







Plan of Correction:

The Agency failed to include evidence of annual competency established for 2024 (PF2, PF4) and for 2023 (PF5). This deficiency has been corrected and is now met. The Agency Manager re-educated the Hr manager and Hr department regarding conducting competency review at least once per year. The Hr manager ensure that competency review will be completed yearly has verbalized understanding and adherence to requirement. PF2, PF4 and PF5 have been corrected and are now in compliance with this standard, the completion date 05/24/24.

The Hr Manager is responsible for implementing this correction. The Hr Manager must assure us that that competency review will be completed yearly. The Hr Manager will review all personnel files until there is 100% compliance. Then they will be reviewed yearly. Thereafter all personnel files will be reviewed upon hire, at 90 days, whenever there is a change in the policy.



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 personnel files (PF), Centers for Disease Control (CDC) Guidelines, and employee (EMP) interview the agency failed to ensure that each employee with direct consumer contact was screened for mycobacterium tuberculosis (TB) in accordance with CDC guidelines for for two (2) of five (5) PFs reviewed (PF1 & 2).

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...HCWs with a baseline positive test for tuberculosis infections should receive one chest radiograph result to exclude tuberculosis disease....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 within the previous 12 months, a single TST can be administered in the new setting. 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.


Review of PFs conducted on April 9, 2024, between approximately 10:30am and 11:30am revealed:

PF1, date of hire (DOH)11/30/23, start of services (SOS) 11/30/23, failed to include evidence of a baseline tuberculosis screening upon hire completed in accordance with CDC guidelines.

PF2, DOH 1/10/23, SOS 1/10/23, failed to include evidence of a baseline tuberculosis screening upon hire completed in accordance with CDC guidelines.


Findings confirmed at exit interview with Manager, Human Resources, Intake Coordinator, Office Coordinator, and Staffing Coordinator on April 9, 2024, at approximately 2:30pm.





Plan of Correction:

The Agency failed to screen employees for TB with direct consumer contact. This deficiency has been corrected and is now met. The Agency Manager has re-educated the Hr manager and Hr department in regards screening employees with direct consumer contact for TB.

The Hr manager and Hr department has verbalized understanding and adherence to this requirement. The Hr manager and Hr department has been required to read the agency's hiring process policy. All current employees' files have been corrected and are now compliant with this policy. Any employee who had a positive PPD result has been removed from any current case, has been required to obtain a chest x-ray to rule out any active TB disease. Any employee with a positive chest x-ray will be required to obtain clearance from a primary care physician to work at the agency. This documentation has been placed in the employee's personnel file; completion date is 05/24/2024.
The Hr Manager is responsible for implementing this correction. The Hr Manager must assure us that upon hire that any staff providing direct consumer contact is screened for TB. The Hr Manager will review all personnel files at hire and monthly until there is 100% compliance. Then they will be reviewed quarterly for one year. Thereafter all personnel files will be reviewed upon hire, at 90 days, whenever there is a change in the policy, and at the time of performance evaluation. The Hr Manager will use a personnel file audit tool to assist in this process. This process will continue on an on-going basis to ensure compliance.



611.56(b) LICENSURE
Health Screening

Name - Component - 00
(b) A home care agency or home care registry 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.

Observations:


Based on review of personnel files (PF), CDC (Centers for Disease Control Control and Prevention) Guidelines, and employee (EMP) interview the agency failed to complete annual Tuberculosis (TB) education for three (3) of four (4) PFs reviewed with at least 12 months of employment (PF2-5).

Findings included:
The CDC guidelines state that 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 PFs conducted on April 9, 2024, between approximately 10:30am and 11:30am revealed:

PF2, date of hire (DOH) 1/10/23, start of services (SOS) 1/10/23, PF failed to contain documentation of annual TB education for 2024.

PF3, DOH 12/25/22, SOS 12/25/22, PF failed to contain documentation of annual TB education for 2023.

PF4, DOH 3/7/23, SOS 3/7/23, PF failed to contain documentation of annual TB education for 2024.

PF5, DOH 7/21/22, SOS 7/21/22, PF failed to contain documentation of annual TB education for 2023.

Findings confirmed at exit interview with Manager, Human Resources, Intake Coordinator, Office Coordinator, and Staffing Coordinator on April 9, 2024, at approximately 2:30pm.






Plan of Correction:

The Agency failed to conduct annual competency. This deficiency has been corrected and is now met. The Agency Manager has re-educated Hr manager, And Hr department regarding conducting and adherence to requirement. All current employees' files have been corrected and are now in compliance with standard, the completion date 05/24/2024.

The HR manager is responsible for implementing this correction. The Hr manager must assure us that upon hire all staff have annual competency. The HR manager will review all personnel files at hire, monthly and yearly until there is 100% compliance. Then they will be reviewed quarterly for one year. Thereafter all personnel files will be reviewed upon hire, at 90 days, whenever there is a change in the policy, and at the time of performance evaluation. This process will continue on an on-going basis to ensure compliance.



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) and interview with owner, the agency failed to, prior to the commencement of services, provide to the consumer, an information packet containing the identity of the direct care worker who will provide the services and 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, for five (5) of five (5) CF (CF1-5).


Findings included:

Review of CFs conducted on April 9, 2024, between approximately 11:30am and 12:30pm revealed:

CF1, start of services (SOS) 7/8/22, CF failed to include the identity of the direct care worker and who to contact at the Department for information about licensure requirements for a home care agency.
CF2, SOS 7/21/22, CF failed to include the identity of the direct care worker and who to contact at the Department for information about licensure requirements for a home care agency.
CF3, SOS 9/21/23, CF failed to include the identity of the direct care worker and who to contact at the Department for information about licensure requirements for a home care agency.
CF4, SOS 4/10/23, CF failed to include the identity of the direct care worker and who to contact at the Department for information about licensure requirements for a home care agency.
CF5, SOS 12/1/23, CF failed to include the identity of the direct care worker and who to contact at the Department for information about licensure requirements for a home care agency.

Findings confirmed at exit interview with Manager, Human Resources, Intake Coordinator, Office Coordinator, and Staffing Coordinator on April 9, 2024, at approximately 2:30pm.







Plan of Correction:

The Agency failed to include the identity of the direct care worker and who to contact at the Department for information about licensure requirements. This deficiency has been corrected and has now met the requirements. The Governing body has re-educated the Administrator. The Administrator has verbalized understanding and adherence to this requirement. The Administrator has been required to read the policy. CF1, CF3, CF4 and CF5 have been corrected, Contact Number for licensure Department was update and are now in compliance, completion date 05/24/2024.
The Administrator is responsible for implementing this correction. The Administrator must assure that upon intaking consumers that the agency has completed everything on consumers files. The Administrator will review all consumer files at intake and monthly until there is 100% compliance. Then they will be reviewed quarterly for one year.



Initial Comments:


Based on the findings of an onsite unannounced state re-licensure survey conducted on April 9, 2024, APlus United Home Care, LLC, was found to be in compliance with the requirements of 35 P.S. 448.809 (b).





Plan of Correction: