Every finding on record at 1047 Home Health & More LLC

This visit was for a Federal/State complaint survey of a Home Health Agency Provider. Survey Dates: 02/19/2026 and 02/20/2026. Complaint: IN002740767, with unrelated deficiencies cited. 12 Month Unduplicated Skilled Admissions: 11 This deficiency report reflects State Findings cited in accordance with 410 IAC 17. Refer to State Form for additional State Findings. Abbreviations: HHA Home Health Aide SN Skilled Nurse RN Registered Nurse CM Clinical Manager POC Plan of Care SOC Start of Care QR completed by Area 3 on 2/24/2026.

Skilled services furnished CFR(s): 484.105(f) Standard: Services furnished. Skilled nursing services and at least one other therapeutic service (physical therapy, speech-language pathology, or occupational therapy; medical social services; or home health aide services) are made available on a visiting basis, in a place of residence used as a patient's home. An HHA must provide at least one of the services described in this subsection directly, but may provide the second service and additional services under arrangement with another agency or organization. This STANDARD is not met as evidenced by: Based on record review and interview, the agency failed to ensure it provided Skilled Nursing and/or one other therapeutic service in 1 of 1 agency. Findings Include: 1. A review of an undated agency policy titled “Services Provided” indicated but was not limited to, “Agency will provide intermittent, part-time or extended hours of skilled nursing and home health aide services ... ” 2. A review of the Home Health Agency Survey Report Form 1572, completed by the Administrator on 02/19/2025, evidenced the services provided were SN and HHA services. 3. On 02/19/2025 at 10:05 AM, during the entrance conference, the Administrator indicated the services the agency provided were SN services and HHAs. 4. A review of an agency document titled “Client Roster” evidenced the current 25 patients had received HHA services only. During an interview on 02/20/2025 at 11:59 AM, the Administrator confirmed the agency’s 25 active patients received HHA services only, and the RNs completed recertifications and supervisory visits for those 25 patients. 5. A review of the clinical record for Patient #5, SOC date of 11/20/2025, contained a POC for the initial certification period 11/24/2025 to 01/22/2026. The POC indicated Patient #5 had orders for SN one time a week for one week, and one time a week for 8 weeks for medication set up and education. Patient #5 had orders for HHA 5 times a week for 9 weeks for personal care assistance. A review of the POC for the certification period from 01/16/2026 to 03/16/2026. The POC indicated Patient #5 had orders for HHA 5 times a week for 9 weeks, for personal care assistance, and SN 1w1 for a recertification assessment. The POC failed to evidence Patient #5 received SN services. A review of a SN visit note dated 01/14/2026 indicated Patient #5 requested to set up their own medications, and SN services were no longer needed. On 02/20/2026 at 11:59 AM, during a review of the Facility Census Form completed by the Administrator on 02/20/2026, evidenced the agency had 0 skilled patients. When asked for clarification regarding previously having 11 skilled patients unduplicated, the Administrator communicated they had no current skilled patients because they were preparing for their Medicare survey with an Accrediting Organization. When asked when the last patient received skilled services, the Administrator indicated Patient #5 had been admitted in November 2025. Patient #5 had been provided medication set up by Skilled Nursing until 01/14/2026. Patient #5 requested no further SN visits due to being able to set up their own medications. The Administrator stated, “I knew we had to provide two services.”