Every finding on record at Caring Hospice Services of Central Pennsylvania LLC

Based on a review of Centers for Disease Control (CDC) guidelines, personnel files (PFs), agency policy/procedure, and interview with agency administrator, it was determined the agency failed to ensure direct care staff, prior to patient contact, that the individual had been screened for and was free from active mycobacterium tuberculosis (TB) for five (5) of seven (7) PFs reviewed (PFs #1, #3-6); failed to complete/maintain onhire TB risk symptom screening assessment (TB-RAQ) for two (2) of seven (7) PFs reviewed (PFs #5-6); and failed to complete/maintain annual TB education for three (PFs #4-5, #7). --- Review conducted on August 26,2024, at approximately 11:30 AM of Centers for Disease Control (CDC) "Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in Health-Care Settings, 2005 revealed: "...Baseline testing for M. Tuberculosis infection is recommended for all newly hired health care workers [HCWs]...If TST [tuberculin skin testing] is used for baseline testing, two-step testing is recommended for HCWs whose initial TST results are negative...If the first-step TST result is negative, the second-step TST should be administered 1--3 weeks after the first TST result was read...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..." *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 conducted on August 26, 2024, at approximately 11:30 AM, of agency's personnel files (PFs) revealed: PF#1 date of hire (doh) 4/15/24, missing onhire #2 TB TST result. PF#3 doh 8/15/22, missing onhire #2 TB TST result. PF#4 doh 7/24/23, missing onhire #2 TB TST result and annual TB education/TB-RAQ 2024. PF#5 doh 6/1/18, missing onhire #2 TB TST result, missing onhire TB-RAQ, and missing annual TB education/TB-RAQ 2022-2024. PF#6 doh 12/28/23, missing onhire #2 TB TST result and missing onhire TB-RAQ. PF#7 doh 3/3/20, missing annual TB education/TB-RAQ 2022-2023. Review conducted on August 26, 2024, at approximately 12:30 PM, of agency policy/procedure HHr.H10 Health/Physical Requirements revealed: Pages 1-2, "... 5. All employees and volunteers are required to have documented evidence of a tuberculin screening prior to patient contact. All employees and volunteers are required to complete the two-step PPD (Mantoux skin test for Tuberculosis) test or TB blood test with an interferon-gamma release assay (IGRA) prior to being hired/volunteering.; ... b. All staff and volunteers need only complete the tuberculosis screening questionnaire each year after hire or date of initial volunteer service." Interview conducted on August 26, 2024, at approximately 12:30 PM, with agency administrator confirmed the above findings.