Every finding on record at All for You Home Health Care LLC

An Emergency Preparedness Survey was conducted by the Indiana Department of Health in accordance with 42 CFR 484.102. Survey Dates: 10/28/2025 - 10/30/2025 Active Census: 12 At this Emergency Preparedness survey, All For You Home Health Care, LLC was found in compliance with Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers and Suppliers, 42 CFR 484.102. QR Completed on 11/06/2025 by A4

This visit was for an Initial Medicaid and State Licensure survey for a Home Health provider. Survey Dates: 10/28/2025 - 10/30/2025 12 Month Unduplicated Admissions: 12 This deficiency report reflects State Findings cited in accordance with 410 IAC 17. ABBREVIATIONS: RN REGISTERED NURSE POC PLAN OF CARE

Only as ordered by a physician CFR(s): 484.60(b)(1) Drugs, services, and treatments are administered only as ordered by a physician or allowed practitioner. This ELEMENT is not met as evidenced by: Based on observation, record review, and interview, the agency failed to ensure the skilled nurse performed wound care only as ordered by the physician for 1 of 3 home visits conducted (Patient #2). Findings include: Review of a policy titled "Wound Care Policy," indicated but was not limited to: "All wound care must be performed by a licensed nurse (RN or LPN under RN supervision following the established care plan (Form 485), or most current physician order…" The Clinical Record for Patient #2, benefit period 10/09/2025 - 12/07/2025, evidenced a POC with wound care orders for a chronic stage four (4) pressure ulcer with new diagnosis of osteomyelitis of the left ischium and pelvis. The order indicated the current orders are cleanse the wound bed with Vashe wound solution (a topical wound cleanser that contains hypochlorous acid), pat dry with gauze, cleanse peri wound (tissue surrounding a wound) skin area with soap and water and pat dry with gauze, pack Vashe moistened gauze, cover with silicone bordered dressing and secure with tape if needed. During a Home Visit with Patient #2 on 10/29/2025 at 12:15 PM, RN 1 cleansed hands and donned gloves to perform wound care. RN 1 collected wound measurements of Patient #2's chronic stage (four) 4 pressure ulcer with new diagnosis of osteomyelitis of the left ischium and pelvis. RN 1 then continued to cleanse the wound bed with Vashe wound solution (a topical wound cleanser that contains hypochlorous acid), packed the wound with Vashe soaked gauze, and cover the wound with a bordered dressing. RN 1 failed to cleanse the peri wound (tissue surrounding a wound) skin area with soap and water and pat dry with gauze as ordered in Patient #5's POC. During an interview on 10/29/2025 at 2:00 PM, RN 1 indicated he/she did not follow the order and perform cleaning around the peri wound area with soap and water. RN 1 indicated he/she has been needing to clarify that part of the wound care order because Patient #2 only has bar soap in the home. He/She indicated the wound care orders have been active as written since the patient's SOC and every time he/she is on the phone with the doctor's office, she forgets to clarify the cleanse with soap and water instructions. 410-IAC- 17-13-1(a)

Visit schedule CFR(s): 484.60(e)(1) Visit schedule, including frequency of visits by HHA personnel and personnel acting on behalf of the HHA. This ELEMENT is not met as evidenced by: Based on record review and interview, the agency failed to ensure all patients received a schedule with frequency of visits and by what personnel for 2 of 3 home visits conducted (Patients #1, #2). Findings include: During a home visit with Patient #1 on 10/29/2025 at 10:00 AM, a review of the patient's folder provided by the agency, failed to evidence a visit schedule of services to be provided by the agency and who would be providing the services. During an interview on 10/29/2025 at 10:31 AM, RN 1 indicated Patient #1 does not have a POC in the home as it's currently not the agency's process. He/She indicated no written care instructions or schedule with frequency of visits and by what disciplines, are in the home. During a home visit with Patient #2 on 10/29/2025 at 12:15 PM, a review of the patient's folder provided by the agency, failed to evidence a visit schedule of services to be provided by the agency and who would be providing the services. During an interview on 10/29/2025 at 12:301 PM, RN 1 indicated Patient #2 does not have a POC in the home as it's currently not the agency's process. He/She indicated no written care instructions or schedule with frequency of visits and by what disciplines, are in the home.

Treatments and therapy services CFR(s): 484.60(e)(3) Any treatments to be administered by HHA personnel and personnel acting on behalf of the HHA, including therapy services. This ELEMENT is not met as evidenced by: Based on record review and interview, the agency failed to ensure all patients received written information regarding treatments to be administered by the home health for 2 of 3 home visits conducted (Patients #1, #2). Findings include: 1.During a home visit with Patient #1 on 10/29/2025 at 10:00 AM, a review of the patient's folder provided by the agency, failed to evidence written information regarding treatments to be provided by the agency and who would be providing the treatments. During an interview on 10/29/2025 at 10:31 AM, RN 1 indicated Patient #1 does not have a POC in the home as it's currently not the agency's process. He/She indicated no written care instructions or schedule with frequency of visits are in the home. 2. During a home visit with Patient #2 on 10/29/2025 at 12:15 PM, a review of the patient's folder provided by the agency, failed to evidence written information regarding treatments to be provided by the agency and who would be providing the treatments. During an interview on 10/29/2025 at 12:301 PM, RN 1 indicated Patient #2 does not have a POC in the home as it's currently not the agency's process. He/She indicated no written care instructions or schedule with frequency of visits and by what disciplines, are in the home.