Every finding on record at Home Health Specialists LLC

Based on the findings of an on-site unannounced home health agency Medicare re-certification survey conducted February 21, 2023, through February 23, 2023, Home Health Specialists, LLC was found to be in compliance with the requirements of 42 CFR, Part 484.22, Subpart B, Conditions of Participation: Home Health Agencies - Emergency Preparedness.

Based on the findings of an on-site unannounced home health agency Medicare re-certification survey conducted February 21, 2023, through February 23, 2023, Home Health Specialists, LLC was found not to be in compliance with the requirements of 42 CFR, Part 484, Subparts B and C, Conditions of Participation: Home Health Agencies.

Ensure that HHA employs qualified personnel CFR(s): 484.105(b)(1)(iv) (iv) Ensure that the HHA employs qualified personnel, including assuring the development of personnel qualifications and policies. This ELEMENT is not met as evidenced by: Based on review of agency policy, personnel files (PF), and an interview with agency staff, the agency failed to ensure each health care worker was screened for and is free from active mycobacterium tuberculosis in accordance with CDC (Centers for Disease Control and Prevention) guidelines, for six (6) of seven (7) PF reviewed. (PF #2, 3, 4, 5, 6, and 7). Findings include: The CDC guidelines state baseline (preplacement) screening and testing, in addition to the IGRA (interferon-gamma release assay) or tuberculin skin test (TST), shall include a symptom screen questionnaire and an individual tuberculosis (TB) risk assessment. Serial screening and testing is not routinely recommended. Annual TB education is recommended. (CDC/MMWR/May 17, 2019/Vol. 68/No. 19). If the Mantoux tuberculin skin test (TST) is used to test health care personnel upon hire (preplacement), two-step testing should be used. This is because some people with latent TB infection have a negative reaction when tested years after being infected. The first TST may stimulate or boost a reaction. Positive reactions to subsequent TSTs could be misinterpreted as a recent infection. Review of agency policy titled “Tuberculosis Screening – Pennsylvania Specific” on February 23, 2023, at approximately 12:30 P.M. states, “Procedure: 1. Prior to contact with patients, the new team member will submit an individual risk assessment, a symptom evaluation, and a TB test (either the interferon gamma-release assay, or IGRA, blood test or the tuberculin skin test).” Review of PFs conducted on February 21, 2023, from approximately 12:00 P.M. to 2:00 P.M. revealed the following: PF# 2, date of re-hire January 16, 2019, contained documentation of a single TST completed on February 29, 2020. The employee was inactive for more than one year with no documentation of a previous TST completed within one year of re-hire. PF #3, date of re-hire July 5, 2021, contained documentation of a single TST completed on September 12, 2022. The employee was inactive for more than one year with no documentation of a previous TST completed within one year of re-hire. PF #4, date of hire March 12, 2013, contained documentation of a single TST completed on April 13, 2013. There was no documentation of a second TST conducted upon hire. PF #5, date of hire October 5, 2021, contained documentation of a single TST completed on September 18, 2021. There was no documentation of a second TST conducted upon hire. PF #6, date of hire November 28, 2022, contained documentation of a single TST completed on October 5, 2022. There was no documentation of a second TST conducted upon hire. PF #7, date of hire June 22, 2009, contained no documentation of a two-step TST conducted upon hire. An interview with the Director of Operations, the Director of Nursing and the Integrations Project Manager on February 23, 2023, at approximately 1:00 P.M. confirmed the above findings.