Penn Asian Senior Services: A Case Study

CCIB received a Corrective Plan of Action (CAP) detailing the visit to the home on 10/18/17 by Service Coordinator, Sally Cano. Ms. Cano arrived at the home, but no one was there. Ms. Cano proceeded to check Delta Home 3 (located next door) and found 2 of Delta Home Care IV residents along with residents from Delta Home Care 3 at the home. As Ms. Cano was leaving, she observed a bus arrive at the Delta Home Care 2. The bus driver reported that there was no staff at the home and that the residents were waiting outside. It was observed the Delta Home Care 2, 3, and IV to be lacking staff. On 10/19/17, RP and Quality Assurance specialist (QAS) Jesus Ozeda went to the facility to observe the staff to resident ratios and to collect the staff schedules

SC received vm from Andy at Marx Medical stated that the Pa’s grab bars was successfully installed but when he attempted to bill for the service he was informed by Promise that the provider code was incorrect. SC reviewed the service order and did not see any problem in the service order so the SC placed a call to the provider and enquired about the billing issue but when the SC called the receptionist stated that Andy was not there yet and when he gets there she will have him call the SC. The SC left contact information and awaits Andy’s call. The SC will f/u with SCS about the about matter. 11:21-11:30

SC meets with SCS to discuss issues highlighted in previous note on 1/14/2016 at 1:30 PM. SC asked SCS to explain how and why EDC are able to bill for a full day of servicer after 4.5 hours. SCS informed SC that that each Wavier service has its own policy and that 4.5 hrs at a day care is considers base on guidelines set forth by Wavier. SC thanks SCS for the explanation and moved on the next issue which was the installation for ERS. SC informed SCS that the provider reported that the service was done in October, 2015 but SC is only being allowed to add service for further dates. SC informed SCS that SC created the service order for the month of February. SCS was able to back date to November, 2015. SC called the provider and informed Tanya

SC complete monitoring phone call on 01/20/2016 with Pa's PAS (Cheryl). Pa reports receiving all services as outlined in ISP. He remains satisfied with services and feels that they meet his current needs. No falls, hospitalization, changes in health status or medication reported by Pa. No outstanding follow up needs identified. The day before SC received a phone call from Cheryl reporting that Pa’s is running low on heating oil and has exhausted all other option and would like PCA emergency fund to supple Pa with heating oil. SC completed the paperwork and gave to SDCS to review and submit. At the time of this call retreated that the paperwork has been submitted and Pa will receive the heating oil as long as he is qualified and has not use

I received a call from Mr Kevin Ziegler regarding her son’s benefits has been reduced. Mr Ziegler stated that his son Kyle, is receiving in Home Care benefits and his mother Patricia Ziegler is the home care provider, through Resource Connections of Oregon (RCO). They received a notification informing them that as a result of a new assessment tool her hours have been cut more than

The organization that I choose is the Portland Asian Health and Services Center (AHSC), which is a non-profit organization and committed to help people who are from Asian in getting more involved with the local Portland community, especially help its clients in health care area. Particularly, most of its clients are elderly people, thus, it also provides many specific health care services for these elderly people.

A child referred (third time; first two were declined) by the inpatient social worker inquired if POA could come that day; as they did not want to send him home until a visit had occurred. This was his second admission in 48 hrs. However, I explained POA is not an emergency home care program, and a scheduled

SC spoke with Pa and CG on 09/30/2015. No falls, hospitalization, changes in health status or medications were reported by Pa or CG. Pa reported that both she and spouse (Travers Russell was not present when SC called; Pa stated he went to the senior center and he’s doing well no unmet needs) are receiving services as outlined in the ISP. Pa’s goals remain unchanged both her and spouse remain satisfied with services and feel that they meeting their current needs. Pa reported that all services are received in the correct type, scope, amount, duration, and frequency as specified in the ISP. Pa self-directed model PAS provide hands on assistance and supervision with bathing, dressing, grooming, toileting, light home support and meal prep; daily

SC completed service coordination task associated with care plan rollover.SC rolled over PPL FMS ongoing monthly service fee, PAS service consumer option model Public Partnership (PPL), receives assistance w/ bathing, dressing, transfers and IADLs 7 days x 4 hours 7-9am and 4-6pm, provider PPL, PAS Taheerah, informal Shirley is informal back up. Pa confirms that she is receiving, type, scope, amount, duration and frequency through Self Directed consumer model. Per Pa, the aide continues to assist the Pa w/ his daily, bathing, grooming, IADLS excluding, money and telephone management. The Pa also, receives 7 frozen dinners weekly from Moms meal to supplement nutritious healthy meals, and Service Coordination via PCA. The Pa's has no informal

SWI spoke to the mother using langue line. The mother reported that someone from NYF contacted her regarding services. The mother further reported that she is unable to meet with the therapy 3 times per week because of her schedule. The mother stated that she works and attends school and is only available on Friday after 4PM. SWI inquires if the mother will be available in the morning before she goes to work. The mother reported that if the therapist can get to her home at 7:30am she is willing to participate in services. The mother reported that she can make herself available on Tuesdays at 7:30am and Fridays after 4pm.

SC complete monitoring phone call with Pa on o3/28/2016. The Pa stated that Tiffany wants him to switch to another PAS provider Progressive Health Care because they offer more money and she wants more hours. The asked the Pa what is that he wants and he stated that he is fine with the way things are now. The SC told the Pa that things will remain as is and if he wants to switch in the feature then he most call the SC himself and request that change. The Pa agrees and the SC continues with monitoring call review use of medical service and ISP. The Pa, who reported no falls, hospitalization, changes in health status or medication reported by Pa. Pa reports receiving all services as outlined in ISP. He remains satisfied with the services and feels

SC created new service order for ERS Medscope as the provider. SC place call to provider and spoke with Alissa and informed her of the new order. Alissa asked when was it done and SC informed her on 1/13/2016 and Alissa reported that she has not received it as yet. SC informed Alissa that this is the second service order for this particular service because it was not done the other two times the service has been ordered. Alissa reported there is nothing in the system for this Pa. SC asked if they have the monthly maintenance service order for ERS and she said yes. SC reviewed Pa care plan and everything looks good. SC asked Alissa to informed SC by 1/21/2016 if she still don’t have it by then. Alissa agrees to to do so and SC end the call.

SC placed a call to Pa’s DCW/dtr Maria and completed monitoring phone call with her. The SC asked the DCW if the basement is cleaned and free of fleas. The SC informed that the SC will share this information with SCS and then housing will contact her directly to schedule another visit for housing inspection for stair ride assessment. The DCW then discussed various issues about the Pa’s home possible in foreclosures and what they are going to do about it. Pa reported no recent falls or hospitalizations or changes in health or functioning. Pa confirmed that she is received her services as specified in the ISP in the following type, scope, amount, frequency and duration: Pa receives Agency Model PAS 4 hours x 7 days per week (9:00am - 2:00pm).

3:37-3:59 p.m.SC received a phone call from Pa’s son (Marqois Drayton) on 07/20/2015MArqois stated he received a packet to complete CAO recertification paper work but, there were no due date on any of the forms. Marqois reported that he completed the forms, has all supplemental documentations (financial) except for one. He is currently waiting for a letter from the life insurance company detailing the policy and value. Marqois is concerned that while he’s waiting for the letter, if there will be any interruption in services if the paper work is not in on time. SC assured Marqois that the services will remain in place as is for now. However, he was advised to contact the life insurance company again and to keep PCA informed because all financial

SC completed service coordination task associated with the Waiver transportation service. Pa requested standing order service for Sunday and Wednesday to go to Church at two different locations. The Pa will attend Sunday service at the Days Inn Hotel at 4200 Roosevelt Blvd. Philadelphia and on Wednesdays she will attend the Genesis Church located at: 644 Rising Sun Ave, Philadelphia, Pa SC reviewed and updated service order for Oracle and SAMS. The SC generated service order and cross check systems to make sure they matches in cost and service ordered. After the service was generated SC added new transportation request but was unable to submit because the Pa did not know her CCT ID number. The SC placed call to in house transportation personnel