Every finding on record at Stonerise Reliable Healthcare LLC

Based on record review, interview and policy review, the agency failed to provide a home health aide written instructions for patient care by a registered nurse. This affected one (Patient #8) of 14 medical records reviewed. The agency's census was 24. Findings include: --- Patient #8 was admitted to the agency on 08/06/24 and began receiving aide services on 08/09/24. The medical record did not contain written instructions for the home health aide by a registered nurse. The findings were shared with Staff A on 08/12/24 at 3:57 PM and confirmed. The agency policy titled "Home Health Aide Services and Training Program", undated, stated the home health aide is assigned to a specific patient by a RN (registered nurse). Written patient care instructions must be prepared by the RN or other appropriate professional who is responsible for supervising the home health aide (PT (physical therapy), OT (occupational therapy) and/or SLP (speech-language pathologist).

Based on record review, interview, policy review and review of the Center for Disease Control and Prevention (CDC) Baseline Tuberculosis Screening and Testing for Health Care Personnel, the agency failed to ensure a two step Mantoux test was administered upon hire. This affected seven (Staff C, F, G, I, L, M and P) of eight personnel files reviewed for TB tests. Findings include: --- Review of personnel files revealed Staff C was hired on 10/05/23. Staff Ts personnel file contained a one-step TB test given on 10/05/23. Staff C did not have a documented negative TB test during the preceding 12 months. Staff F was hired on 02/28/24. Staff Fs personnel file contained a one-step TB test was given on 03/19/24. Staff F did not have a documented negative TB test during the preceding 12 months. Staff G was hired on 03/13/24. Staff Gs personnel file contained a one-step TB test given on 03/19/24. Staff G did not have a documented negative TB test during the preceding 12 months. Staff I was hired on 03/15/22. Staff Is personnel file contained a one-step TB test given on 03/07/22. Staff I did not have a documented negative TB test during the preceding 12 months. Staff L was hired on 07/24/23. Staff Ls personnel file contained a one-step TB test given on 07/31/23. Staff L did not have a documented negative TB test during the preceding 12 months. Staff M was hired on 06/22/22. Staff Ms personnel file contained a one-step TB test given on 06/21/22. Staff M did not have a documented negative TB test during the preceding 12 months. Staff P was hired on 02/16/24. Staff P's personnel file contained a one-step TB test given on 02/12/24. Staff P did not have a documented negative TB test during the preceding 12 months. The findings were shared with Staff H on 08/15/24 at 1:15 PM and confirmed. The CDC's Baseline Tuberculosis Screening and Testing for Health Care Personnel, dated 12/19/23, stated two-step testing is recommended for the initial TB skin test for adults who may be tested periodically, such as health care personnel. This procedure is especially important for settings that are classified as low risk where testing is indicated only upon exposure. Review of the facility's "Occupational Exposure to Tuberculosis/Prevention of Transmission of TB Plan", undated, stated (undated, unnumbered) stated during the new hire physical, employees who have potential for exposure to M. tuberculosis, including those with a history of BCG (Bacille Calmette-Guérin) vaccination, will have a baseline TB Test. For employees who have not had a documented negative TB test during the preceding 12 months, the baseline TB testing will include the two-step method or use of the Blood Assay for M. Tuberculosis (BAMT) testing process. Agency employees considered at risk include all patient care staff. Supervisory personnel who make even occasional home visits are also considered at risk.