Every finding on record at Able Beings Home Healthcare LLC

An Emergency Preparedness Survey was conducted by the Indiana Department of Health in accordance with 42 CFR §484.102 Survey Dates: 08/25/2025 and 08/26/2025. Active Census: 9 At this Emergency Preparedness survey, Able Beings Home Healthcare LLC. was found to be in compliance with Emergency Preparedness Requirements for a Medicaid Participating Providers and Suppliers, 42 CFR §484.102. QR completed by Area 3 on 8/28/2025.

This visit was for an Initial Federal Certification and State Licensure survey for a Home Health provider. Survey Dates: 08/25/2025 and 08/26/2025. 12 Month Unduplicated Admissions: 10 This deficiency report reflects State Findings cited in accordance with 410 IAC 17. Abbreviations: HHA Home Health Aide OASIS Outcome and Assessment Information Set RN Registered Nurse SOC Start of care CM Clinical Manager SN Skilled Nursing POC Plan of Care QR completed by Area 3 on 8/28/2025.

Discharge or Transfer Summary Content CFR(s): 484.58(b)(1) Standard: Discharge or transfer summary content. The HHA must send all necessary medical information pertaining to the patient's current course of illness and treatment, post-discharge goals of care, and treatment preferences, to the receiving facility or health care practitioner to ensure the safe and effective transition of care. This STANDARD is not met as evidenced by: Based on record review and interview, the agency failed to ensure the patient's transfer/discharge summary contained necessary medical information pertinent to the patient’s care had been provided to the healthcare practitioner and receiving facility, thereby ensuring safe transfer of care for 1 of 1 patients transferred and discharged from care. (Patient: Patient #10) Findings Include: 1. A review of an undated agency policy titled “Transfer/Discharge Criteria” indicated, but was not limited to, “ … Patients will be transferred or discharged from Able Beings Home Healthcare when their care needs change … Communication: …will be communicated to the patient, their family, and all involved healthcare providers to ensure continuity of care. A copy of the discharge summary will be provided to the patient’s primary care provider … ” 2. A review of the inactive record for Patient #10, SOC 07/31/2025 and discharge transfer date of 08/05/2025, contained a transfer discharge OASIS Assessment dated 08/05/2025. The Assessment completed on 08/05/2025, electronically signed by the Administrator/Clinical Manager, indicated Patient #10 had been admitted to an acute care facility and had been discharged from the home health agency. The clinical record failed to evidence a transfer/discharge summary or that it had been sent to the acute care facility and the patient’s primary care provider for continuity of care. During an interview on 08/26/2025 at 9:57 AM, when questioned about the location of the transfer/discharge summary in Patient #10’s clinical record, the Administrator/Clinical Manager stated, “No, I did not complete a transfer discharge summary. No, I did not send to the patient’s physician or the acute care facility.” 410 IAC 17-13-2(a)(b)(9)

Plan of care CFR(s): 484.60(a)(1) Each patient must receive the home health services that are written in an individualized plan of care that identifies patient-specific measurable outcomes and goals, and which is established, periodically reviewed, and signed by a doctor of medicine, osteopathy, or podiatry acting within the scope of his or her state license, certification, or registration. If a physician or allowed practitioner refers a patient under a plan of care that cannot be completed until after an evaluation visit, the physician or allowed practitioner is consulted to approve additions or modifications to the original plan. This STANDARD is not met as evidenced by: Based on record review and interview, the agency failed to ensure each individualized POC included the duration of HHA frequency for 1 of 1 active patient receiving HHA services. (Patient #1) Findings Include: 1. A review of an undated agency policy titled “Plan of Care” indicated, but was not limited to, “ … The plan of care includes: … Frequency of visits and duration … ” 2. A review of the clinical record for Patient #1, SOC date of 07/14/2025, contained a POC electronically signed by the Administrator/Clinical Manager, and dated 07/14/2025, for the initial certification period 07/14/2025 through 09/11/2025. The POC indicated Patient #1 had orders for a Skilled Nurse frequency and duration of 2 times a week for 9 weeks, and a HHA frequency and duration of Monday through Friday, 6 hours, and Saturday and Sunday, 2 hours; but failed to evidence the duration of the HHA visits. A review of the agency document titled “Aide Plan of Care” indicated frequency and duration for HHA, 7 times a week for 9 weeks; Monday through Friday, 6 hours a day, and Saturday and Sunday, 2 hours a day. During an interview on 08/26/2025 at 10:58 AM, when questioned regarding the duration of the HHA visits on the POC, the Administrator/Clinical Manager reviewed the document and stated, “No, there is no duration. It should be for 9 weeks. I typed too fast.” 410 IAC 17-13-1(a)(1)(D)(iii)

Infection Prevention CFR(s): 484.70(a) Standard: Infection Prevention. The HHA must follow accepted standards of practice, including the use of standard precautions, to prevent the transmission of infections and communicable diseases. This STANDARD is not met as evidenced by: Based on observation, record review, and interview, the agency failed to follow standard precautions to prevent the transmission of infection and communicable diseases by not practicing proper hand hygiene in 1 of 1 HHA home visits observed. (Employee: HHA 1) Findings Include: 1. A review of an undated agency policy titled “Hand Hygiene/Hand Washing/Hand Cleansing” indicated, but was not limited to, “ … To prevent transfer of germs and transmission of infections to patients and caregivers … 1. Indications for Hand Hygiene/Hand Washing/ Hand Cleansing are: Before and after direct patient care … Before and after each procedure … After contact with contaminated materials … ” 2. During a home visit at Patient #1’s residence on 08/25/2025 at 1:30 PM, observed HHA 1 providing a bed bath to Patient #1. HHA 1 performed hand hygiene donned new gloves and washed Patient #1 trunk and tucked Patient #1’s soiled brief and chuck under Patient #1, discarded their gloves in the trash bag and donned new gloves without performing hand hygiene. HHA 1 washed Patient #1’s buttocks area, discarded the soiled chuck and brief in the trash bag, and then discarded their gloves in the trash, and donned new gloves. HHA 1 failed to perform hand hygiene before donning new gloves. During an interview on 08/25/2025 at 2:10 AM, when questioned regarding hand hygiene after gloves are removed, HHA 1 confirmed hand hygiene should had been done when gloves are removed. During an interview on 08/25/2025 at 4:20 PM, when reviewed the home visit observations, and HHA 1 not performing hand hygiene during Patient #1’s bed bath, the Administrator/Clinical Manager confirmed they had observed HHA 1 not performing hand hygiene after gloves had been removed. 410 IAC 17-12-1(m)