Every finding on record at VNA of Northwest PA, LLC

Based on a review of agency policy and procedures; patient clinical records (CR); agency interdisciplinary group (IDG) meeting sign in sheets; agency admission packet information provided to patients; and staff (EMP) interview, the agency failed to ensure that a social worker completed comprehensive assessments for 7 (seven) of 7(seven) clinical records reviewed. (CR1-7) Findings Included: A review on 6/4/2024 at approximately 11:30 a.m. of agency IDG meeting sign-in sheets from 2/28/2024 to 6/4/2024 revealed that the electronic signature date of attendance for the "Social Worker" was not signed [blank] and the "Name" indicated "services declined". A review of patient Clinical Records (CR) conducted on 6/4/2024 and 6/5/2024, revealed the following: CR1 reviewed on 6/4/2024 at approximately 12:00pm - start of care (SOC) date 2/12/2023: Certification period 4/7/2024 through 6/5/2024. There was no documentation in the clinical record that a social worker completed comprehensive assessments. CR2 reviewed on 6/4/2024 at approximately 1:45pm - start of care (SOC) date 4/24/2024: Certification period 4/24/2024 through 7/22/2024. There was no documentation in the clinical record that a social worker completed comprehensive assessments CR3 reviewed on 6/4/2024 at approximately 2:45pm - start of care (SOC) date 5/14/2024: Certification period 5/14/2024 through 8/11/2024. There was no documentation in the clinical record that a social worker completed comprehensive assessments CR4 reviewed on 6/5/2024 at approximately 12:15pm - start of care (SOC) date 3/20/2024: Certification period 3/20/2024 through 6/17/2024. There was no documentation in the clinical record that a social worker completed comprehensive assessments CR5 reviewed on 6/5/2024 at approximately 12:50pm - start of care (SOC) date 2/23/2022: Certification period 4/13/2024 through 6/11/2024. There was no documentation in the clinical record that a social worker completed comprehensive assessments. CR6 reviewed on 6/5/2024 at approximately 1:30pm - start of care (SOC) date 5/20/2024: Certification period 5/20/2024 through 8/17/2024. There was no documentation in the clinical record that a social worker completed comprehensive assessments. CR7 reviewed on 6/5/2024 at approximately 2:15pm - start of care (SOC) date 5/30/2024: Certification period 5/30/2024 through 8/27/2024. There was no documentation in the clinical record that a social worker completed comprehensive assessments. A review on 6/4/2024 at approximately 3:00 p.m. of agency policy and procedures revealed: "Title: Interdisciplinary Group; Policy #: HOSP3037... POLICY: VNA of Northwest PA designates an IDG composed of qualified individuals who assess, plan, provide and evaluate the care and services provided to hospice patients/caregivers... PROCEDURE: 1. The IDG at VNA of Northwest PA includes, at a minimum, the following individuals: a. a doctor of medicine or osteopathy; b. a registered nurse; c. a Social Worker; d. a pastoral or other counselor..." A review on 6/4/2024 at approximately 3:15 p.m. of agency admission packet information provided to patients revealed: "Social, Emotional and Spiritual Care; Social Work Services: Hospice social work provides education, counseling, support and resources for patients and families..." An interview with EMP1 on 6/4/2024 at approximately 3:30 p.m. confirmed the above findings. When asked if the agency has a social worker or equivalent that attends IDG meetings, EMP1 stated "No. We have been actively recruiting for a replacement social worker since our previous one quit. Her last year of service with us was in 2022." When asked about the above findings, EMP1 stated "If there is no signature, (he/she) was not there." When asked why the "Name" of the social worker indicated "services declined", EMP1 stated "We don't have an employed social worker to fill the role, so we marked services declined."

Based on a review of agency policy and procedures; patient clinical records (CR); agency interdisciplinary group (IDG) meeting sign in sheets; agency admission packet information provided to patients; and staff (EMP) interview, the agency failed to include a social worker as a member of the IDG for 7 (seven) of 7(seven) clinical records reviewed. (CR1-7) Findings Included: A review on 6/4/2024 at approximately 11:30 a.m. of agency IDG meeting sign-in sheets from 2/28/2024 to 6/4/2024 revealed that the electronic signature date of attendance for the "Social Worker" was not signed [blank] and the "Name" indicated "services declined". A review of patient Clinical Records (CR) conducted on 6/4/2024 and 6/5/2024, revealed the following: CR1 reviewed on 6/4/2024 at approximately 12:00pm - start of care (SOC) date 2/12/2023: Certification period 4/7/2024 through 6/5/2024. There was no documentation in the clinical record of a social worker assessment, no record of social worker attending IDG meetings. CR2 reviewed on 6/4/2024 at approximately 1:45pm - start of care (SOC) date 4/24/2024: Certification period 4/24/2024 through 7/22/2024. There was no documentation in the clinical record of a social worker assessment, no record of social worker attending IDG meetings. CR3 reviewed on 6/4/2024 at approximately 2:45pm - start of care (SOC) date 5/14/2024: Certification period 5/14/2024 through 8/11/2024. There was no documentation in the clinical record of a social worker assessment, no record of social worker attending IDG meetings. CR4 reviewed on 6/5/2024 at approximately 12:15pm - start of care (SOC) date 3/20/2024: Certification period 3/20/2024 through 6/17/2024. There was no documentation in the clinical record of a social worker assessment, no record of social worker attending IDG meetings. CR5 reviewed on 6/5/2024 at approximately 12:50pm - start of care (SOC) date 2/23/2022: Certification period 4/13/2024 through 6/11/2024. There was no documentation in the clinical record of a social worker assessment, no record of social worker attending IDG meetings. CR6 reviewed on 6/5/2024 at approximately 1:30pm - start of care (SOC) date 5/20/2024: Certification period 5/20/2024 through 8/17/2024. There was no documentation in the clinical record of a social worker assessment, no record of social worker attending IDG meetings. CR7 reviewed on 6/5/2024 at approximately 2:15pm - start of care (SOC) date 5/30/2024: Certification period 5/30/2024 through 8/27/2024. There was no documentation in the clinical record of a social worker assessment, no record of social worker attending IDG meetings. A review on 6/4/2024 at approximately 3:00 p.m. of agency policy and procedures revealed: "Title: Interdisciplinary Group; Policy #: HOSP3037... POLICY: VNA of Northwest PA designates an IDG composed of qualified individuals who assess, plan, provide and evaluate the care and services provided to hospice patients/caregivers... PROCEDURE: 1. The IDG at VNA of Northwest PA includes, at a minimum, the following individuals: a. a doctor of medicine or osteopathy; b. a registered nurse; c. a Social Worker; d. a pastoral or other counselor..." A review on 6/4/2024 at approximately 3:15 p.m. of agency admission packet information provided to patients revealed: "Social, Emotional and Spiritual Care; Social Work Services: Hospice social work provides education, counseling, support and resources for patients and families..." An interview with EMP1 on 6/4/2024 at approximately 3:30 p.m. confirmed the above findings. When asked if the agency has a social worker or equivalent that attends IDG meetings, EMP1 stated "No. We have been actively recruiting for a replacement social worker since our previous one quit. Her last year of service with us was in 2022." When asked about the above findings, EMP1 stated "If there is no signature, (he/she) was not there." When asked why the "Name" of the social worker indicated "services declined", EMP1 stated "We don't have an employed social worker to fill the role, so we marked services declined."

Based on a review of agency employee roster, policy and procedures, agency interdisciplinary group (IDG) meeting sign in sheets, agency admission packet information provided to patients, and staff (EMP) interview, the agency failed to ensure that a social worker was employed by the agency to provide core services of social, emotional and spiritual Care. The agency failed to provide services in accordance with acceptable standards of practice: L594 - the agency failed to provide services of a medical social worker L595 - the agency failed to provide counseling services to the patient and family - social worker not employed This Condition is not met based on the above non-compliance but did not result in Immediate Jeopardy. Cross reference above mentioned tags for additional information.

Based on a review of agency policy and procedures; patient clinical records (CR); agency interdisciplinary group (IDG) meeting sign in sheets; agency admission packet information provided to patients; and staff (EMP) interview, the agency failed to provide services of a qualified social worker for 7 (seven) of 7(seven) clinical records reviewed. (CR1-7) Findings Included: A review on 6/4/2024 at approximately 11:30 a.m. of agency IDG meeting sign-in sheets from 2/28/2024 to 6/4/2024 revealed that the electronic signature date of attendance for the "Social Worker" was not signed [blank] and the "Name" indicated "services declined". A review of patient Clinical Records (CR) conducted on 6/4/2024 and 6/5/2024, revealed the following: CR1 reviewed on 6/4/2024 at approximately 12:00pm - start of care (SOC) date 2/12/2023: Certification period 4/7/2024 through 6/5/2024. There was no documentation in the clinical record of a social worker assessment, no record of social worker attending IDG meetings. CR2 reviewed on 6/4/2024 at approximately 1:45pm - start of care (SOC) date 4/24/2024: Certification period 4/24/2024 through 7/22/2024. There was no documentation in the clinical record of a social worker assessment, no record of social worker attending IDG meetings. CR3 reviewed on 6/4/2024 at approximately 2:45pm - start of care (SOC) date 5/14/2024: Certification period 5/14/2024 through 8/11/2024. There was no documentation in the clinical record of a social worker assessment, no record of social worker attending IDG meetings. CR4 reviewed on 6/5/2024 at approximately 12:15pm - start of care (SOC) date 3/20/2024: Certification period 3/20/2024 through 6/17/2024. There was no documentation in the clinical record of a social worker assessment, no record of social worker attending IDG meetings. CR5 reviewed on 6/5/2024 at approximately 12:50pm - start of care (SOC) date 2/23/2022: Certification period 4/13/2024 through 6/11/2024. There was no documentation in the clinical record of a social worker assessment, no record of social worker attending IDG meetings. CR6 reviewed on 6/5/2024 at approximately 1:30pm - start of care (SOC) date 5/20/2024: Certification period 5/20/2024 through 8/17/2024. There was no documentation in the clinical record of a social worker assessment, no record of social worker attending IDG meetings. CR7 reviewed on 6/5/2024 at approximately 2:15pm - start of care (SOC) date 5/30/2024: Certification period 5/30/2024 through 8/27/2024. There was no documentation in the clinical record of a social worker assessment, no record of social worker attending IDG meetings. A review on 6/4/2024 at approximately 3:00 p.m. of agency policy and procedures revealed: "Title: Interdisciplinary Group; Policy #: HOSP3037... POLICY: VNA of Northwest PA designates an IDG composed of qualified individuals who assess, plan, provide and evaluate the care and services provided to hospice patients/caregivers... PROCEDURE: 1. The IDG at VNA of Northwest PA includes, at a minimum, the following individuals: a. a doctor of medicine or osteopathy; b. a registered nurse; c. a Social Worker; d. a pastoral or other counselor..." A review on 6/4/2024 at approximately 3:15 p.m. of agency admission packet information provided to patients revealed: "Social, Emotional and Spiritual Care; Social Work Services: Hospice social work provides education, counseling, support and resources for patients and families..." An interview with EMP1 on 6/4/2024 at approximately 3:30 p.m. confirmed the above findings. When asked if the agency has a social worker or equivalent that attends IDG meetings, EMP1 stated "No. We have been actively recruiting for a replacement social worker since our previous one quit. Her last year of service with us was in 2022." When asked about the above findings, EMP1 stated "If there is no signature, (he/she) was not there." When asked why the "Name" of the social worker indicated "services declined", EMP1 stated "We don't have an employed social worker to fill the role, so we marked services declined."

Based on a review of agency policy and procedures; patient clinical records (CR); agency interdisciplinary group (IDG) meeting sign in sheets; agency admission packet information provided to patients; and staff (EMP) interview, the agency failed to ensure that a social worker was employed by the agency to make counseling services available for the patient and family for 7 (seven) of 7(seven) clinical records reviewed. (CR1-7) Findings Included: A review on 6/4/2024 at approximately 11:30 a.m. of agency IDG meeting sign-in sheets from 2/28/2024 to 6/4/2024 revealed that the electronic signature date of attendance for the "Social Worker" was not signed [blank] and the "Name" indicated "services declined". A review of patient Clinical Records (CR) conducted on 6/4/2024 and 6/5/2024, revealed the following: CR1 reviewed on 6/4/2024 at approximately 12:00pm - start of care (SOC) date 2/12/2023: Certification period 4/7/2024 through 6/5/2024. There was no documentation in the clinical record of a social worker assessment, no record of social worker attending IDG meetings, no record of social worker providing counseling visits. CR2 reviewed on 6/4/2024 at approximately 1:45pm - start of care (SOC) date 4/24/2024: Certification period 4/24/2024 through 7/22/2024. There was no documentation in the clinical record of a social worker assessment, no record of social worker attending IDG meetings, no record of social worker providing counseling visits. CR3 reviewed on 6/4/2024 at approximately 2:45pm - start of care (SOC) date 5/14/2024: Certification period 5/14/2024 through 8/11/2024. There was no documentation in the clinical record of a social worker assessment, no record of social worker attending IDG meetings, no record of social worker providing counseling visits. CR4 reviewed on 6/5/2024 at approximately 12:15pm - start of care (SOC) date 3/20/2024: Certification period 3/20/2024 through 6/17/2024. There was no documentation in the clinical record of a social worker assessment, no record of social worker attending IDG meetings, no record of social worker providing counseling visits. CR5 reviewed on 6/5/2024 at approximately 12:50pm - start of care (SOC) date 2/23/2022: Certification period 4/13/2024 through 6/11/2024. There was no documentation in the clinical record of a social worker assessment, no record of social worker attending IDG meetings, no record of social worker providing counseling visits. CR6 reviewed on 6/5/2024 at approximately 1:30pm - start of care (SOC) date 5/20/2024: Certification period 5/20/2024 through 8/17/2024. There was no documentation in the clinical record of a social worker assessment, no record of social worker attending IDG meetings, no record of social worker providing counseling visits. CR7 reviewed on 6/5/2024 at approximately 2:15pm - start of care (SOC) date 5/30/2024: Certification period 5/30/2024 through 8/27/2024. There was no documentation in the clinical record of a social worker assessment, no record of social worker attending IDG meetings, no record of social worker providing counseling visits. A review on 6/4/2024 at approximately 3:00 p.m. of agency policy and procedures revealed: "Title: Interdisciplinary Group; Policy #: HOSP3037... POLICY: VNA of Northwest PA designates an IDG composed of qualified individuals who assess, plan, provide and evaluate the care and services provided to hospice patients/caregivers... PROCEDURE: 1. The IDG at VNA of Northwest PA includes, at a minimum, the following individuals: a. a doctor of medicine or osteopathy; b. a registered nurse; c. a Social Worker; d. a pastoral or other counselor..." A review on 6/4/2024 at approximately 3:15 p.m. of agency admission packet information provided to patients revealed: "Social, Emotional and Spiritual Care; Social Work Services: Hospice social work provides education, counseling, support and resources for patients and families..." An interview with EMP1 on 6/4/2024 at approximately 3:30 p.m. confirmed the above findings. When asked if the agency has a social worker or equivalent that attends IDG meetings, EMP1 stated "No. We have been actively recruiting for a replacement social worker since our previous one quit. Her last year of service with us was in 2022." When asked about the above findings, EMP1 stated "If there is no signature, (he/she) was not there." When asked why the "Name" of the social worker indicated "services declined", EMP1 stated "We don't have an employed social worker to fill the role, so we marked services declined."

Based on a review of agency employee roster, patient clinical records, policy and procedures, agency interdisciplinary group (IDG) meeting sign in sheets, agency admission packet information provided to patients, governing body meeting minutes and staff (EMP) interview, the agency failed to organize, manage, and administer its resources to provide the hospice care and services to patients, caregivers and families necessary for the palliation and management of the terminal illness adn related conditions. 651 - the governing body failed to assume full legal authority and responsibility for the management of the hospice, the provision of all hospice services. 652 - the agency failed to provide medical social services. This Condition is not met based on the above non-compliance but did not result in Immediate Jeopardy. Cross reference above mentioned tags for additional information.

Based on a review of agency policy and procedures; patient clinical records (CR); agency interdisciplinary group (IDG) meeting sign in sheets; agency admission packet information provided to patients; and staff (EMP) interview, the governing body failed to assume full legal authority and responsibility for the management of the hospice, the provision of all hospice services for 7 (seven) of 7(seven) clinical records reviewed. (CR1-7) Findings Included: A review on 6/4/2024 at approximately 11:30 a.m. of agency IDG meeting sign-in sheets from 2/28/2024 to 6/4/2024 revealed that the electronic signature date of attendance for the "Social Worker" was not signed [blank] and the "Name" indicated "services declined". A review of patient Clinical Records (CR) conducted on 6/4/2024 and 6/5/2024, revealed the following: CR1 reviewed on 6/4/2024 at approximately 12:00pm - start of care (SOC) date 2/12/2023: Certification period 4/7/2024 through 6/5/2024. There was no documentation in the clinical record of a social worker completion of comprehensive assessment, no documentation of counseling provided by social worker. CR2 reviewed on 6/4/2024 at approximately 1:45pm - start of care (SOC) date 4/24/2024: Certification period 4/24/2024 through 7/22/2024. There was no documentation in the clinical record of a social worker completion of comprehensive assessment, no documentation of counseling provided by social worker. CR3 reviewed on 6/4/2024 at approximately 2:45pm - start of care (SOC) date 5/14/2024: Certification period 5/14/2024 through 8/11/2024. There was no documentation in the clinical record of a social worker completion of comprehensive assessment, no documentation of counseling provided by social worker. CR4 reviewed on 6/5/2024 at approximately 12:15pm - start of care (SOC) date 3/20/2024: Certification period 3/20/2024 through 6/17/2024. There was no documentation in the clinical record of a social worker completion of comprehensive assessment, no documentation of counseling provided by social worker. CR5 reviewed on 6/5/2024 at approximately 12:50pm - start of care (SOC) date 2/23/2022: Certification period 4/13/2024 through 6/11/2024. There was no documentation in the clinical record of a social worker completion of comprehensive assessment, no documentation of counseling provided by social worker.. CR6 reviewed on 6/5/2024 at approximately 1:30pm - start of care (SOC) date 5/20/2024: Certification period 5/20/2024 through 8/17/2024. There was no documentation in the clinical record of a social worker completion of comprehensive assessment, no documentation of counseling provided by social worker. CR7 reviewed on 6/5/2024 at approximately 2:15pm - start of care (SOC) date 5/30/2024: Certification period 5/30/2024 through 8/27/2024. There was no documentation in the clinical record of a social worker completion of comprehensive assessment, no documentation of counseling provided by social worker. A review on 6/4/2024 at approximately 3:00 p.m. of agency policy and procedures revealed: "Title: Interdisciplinary Group; Policy #: HOSP3037... POLICY: VNA of Northwest PA designates an IDG composed of qualified individuals who assess, plan, provide and evaluate the care and services provided to hospice patients/caregivers... PROCEDURE: 1. The IDG at VNA of Northwest PA includes, at a minimum, the following individuals: a. a doctor of medicine or osteopathy; b. a registered nurse; c. a Social Worker; d. a pastoral or other counselor..." A review on 6/4/2024 at approximately 3:15 p.m. of agency admission packet information provided to patients revealed: "Social, Emotional and Spiritual Care; Social Work Services: Hospice social work provides education, counseling, support and resources for patients and families..." An interview with EMP1 on 6/4/2024 at approximately 3:30 p.m. confirmed the above findings. When asked if the agency has a social worker or equivalent that attends IDG meetings, EMP1 stated "No. We have been actively recruiting for a replacement social worker since our previous one quit. Her last year of service with us was in 2022." When asked about the above findings, EMP1 stated "If there is no signature, (he/she) was not there." When asked why the "Name" of the social worker indicated "services declined", EMP1 stated "We don't have an employed social worker to fill the role, so we marked services declined."

Based on a review of agency policy and procedures; patient clinical records (CR); agency interdisciplinary group (IDG) meeting sign in sheets; agency admission packet information provided to patients; and staff (EMP) interview, the agency failed to provide medical social services for 7 (seven) of 7(seven) clinical records reviewed. (CR1-7) Findings Included: A review on 6/4/2024 at approximately 11:30 a.m. of agency IDG meeting sign-in sheets from 2/28/2024 to 6/4/2024 revealed that the electronic signature date of attendance for the "Social Worker" was not signed [blank] and the "Name" indicated "services declined". A review of patient Clinical Records (CR) conducted on 6/4/2024 and 6/5/2024, revealed the following: CR1 reviewed on 6/4/2024 at approximately 12:00pm - start of care (SOC) date 2/12/2023: Certification period 4/7/2024 through 6/5/2024. There was no documentation in the clinical record that the agency provided medical social services. CR2 reviewed on 6/4/2024 at approximately 1:45pm - start of care (SOC) date 4/24/2024: Certification period 4/24/2024 through 7/22/2024. There was no documentation in the clinical record that the agency provided medical social services. CR3 reviewed on 6/4/2024 at approximately 2:45pm - start of care (SOC) date 5/14/2024: Certification period 5/14/2024 through 8/11/2024. There was no documentation in the clinical record that the agency provided medical social services. CR4 reviewed on 6/5/2024 at approximately 12:15pm - start of care (SOC) date 3/20/2024: Certification period 3/20/2024 through 6/17/2024. There was no documentation in the clinical record that the agency provided medical social services. CR5 reviewed on 6/5/2024 at approximately 12:50pm - start of care (SOC) date 2/23/2022: Certification period 4/13/2024 through 6/11/2024. There was no documentation in the clinical record that the agency provided medical social services.. CR6 reviewed on 6/5/2024 at approximately 1:30pm - start of care (SOC) date 5/20/2024: Certification period 5/20/2024 through 8/17/2024. There was no documentation in the clinical record that the agency provided medical social services. CR7 reviewed on 6/5/2024 at approximately 2:15pm - start of care (SOC) date 5/30/2024: Certification period 5/30/2024 through 8/27/2024. There was no documentation in the clinical record that the agency provided medical social services. A review on 6/4/2024 at approximately 3:00 p.m. of agency policy and procedures revealed: "Title: Interdisciplinary Group; Policy #: HOSP3037... POLICY: VNA of Northwest PA designates an IDG composed of qualified individuals who assess, plan, provide and evaluate the care and services provided to hospice patients/caregivers... PROCEDURE: 1. The IDG at VNA of Northwest PA includes, at a minimum, the following individuals: a. a doctor of medicine or osteopathy; b. a registered nurse; c. a Social Worker; d. a pastoral or other counselor..." A review on 6/4/2024 at approximately 3:15 p.m. of agency admission packet information provided to patients revealed: "Social, Emotional and Spiritual Care; Social Work Services: Hospice social work provides education, counseling, support and resources for patients and families..." An interview with EMP1 on 6/4/2024 at approximately 3:30 p.m. confirmed the above findings. When asked if the agency has a social worker or equivalent that attends IDG meetings, EMP1 stated "No. We have been actively recruiting for a replacement social worker since our previous one quit. Her last year of service with us was in 2022." When asked about the above findings, EMP1 stated "If there is no signature, (he/she) was not there." When asked why the "Name" of the social worker indicated "services declined", EMP1 stated "We don't have an employed social worker to fill the role, so we marked services declined."

Based on review of the Pennsylvania Older Adult Protective Services Act (OAPSA), volunteer files (VF) and employee personnel files (PF) and based on interview with the agency administrator (Employee (EMP)#1), the hospice failed to ensure a Pennsylvania State Police (PSP) criminal history report and/or Federal Bureau of Investigation (FBI) criminal history record was obtained for five (5) of six (6) hospice employees (PF#2, PF#3, PF#4, PF#5 and PF#6) and three (3) of nine (9) volunteers (VF#1, VF#4 and VF#9) who provided hospice services in Pennsylvania. Findings include: On 6/6/2024 from approximately 9:30 a.m. to 12:55 p.m. and 6/7/2024 from approximately 9:20 a.m. to 11:00 a.m. a review of the hospice employee personnel files and volunteer files revealed: PF#2, Date of Hire (DOH): 4/25/-2022 - no documentation present in PF of PSP and/or FBI criminal background check was completed. PF#3, Date of Hire (DOH): 1/17/2022 - no documentation present in PF of PSP and/or FBI criminal background check was completed. PF#4, Date of Hire (DOH): 4/10/2023 - no documentation present in PF of PSP and/or FBI criminal background check was completed. PF#5, Date of Hire (DOH): 10/17/2023 - no documentation present in PF of PSP and/or FBI criminal background check was completed. PF#6, Date of Hire (DOH): 12/18/2023 - no documentation present in PF of PSP and/or FBI criminal background check was completed. VF# 1, Date of Hire (DOH): 3/1/2007 - no documentation present in VF of PSP and/or FBI criminal background check was completed. VF# 4, Date of Hire (DOH): 2/1/2009 - no documentation present in VF of PSP and/or FBI criminal background check was completed. VF# 9, Date of Hire (DOH): 3/5/1991 - no documentation present in VF of PSP and/or FBI criminal background check was completed. On 6/7/2024 at approximately 1:55 PM, review of the Older Adult Protective Services Act (Pennsylvania Act 169 of 1996 as amended by Act 13 of 1997) revealed the following as documented on the Pennsylvania Department of Aging website: "The Act 169-1996 Amendment to OAPSA requires a criminal background check for all employees and administrators of a facility...In addition, the Pennsylvania Department of Health has defined home health care organization or agency to include hospices... and the criminal background check requirement is that all facility applicants must submit with their employment application a criminal history report from the Pennsylvania State Police... if the applicant is not a resident of Pennsylvania, or has not been a resident of Pennsylvania for the entire two years immediately preceding employment application, then in addition to the report from the PA State Police, a report of Federal (FBI) criminal history record information must be obtained from the Federal Bureau of Investigation through the PA Department of Aging which has been designated by statute as the intermediary... Notwithstanding section 502, administrators may employ applicants on a provisional basis for a single period not to exceed 30 days or, for applicants under section 502(a)(2), a period of 90 days"... Interview with agency administrator (EMP1) conducted on 6/6/2024 at approximately 3:00 p.m. and email correspondence with volunteer coordinator on 6/7/2024 at approximately 1:00 pm. confirmed the above findings.