Every finding on record at First Rate Caregivers Health LLC

An Emergency Preparedness Survey was conducted by the Indiana Department of Health in accordance with 42 CFR 484.102 Survey Dates: 06/10/2025, 06/11/2025 and 06/12/2025 Active Census: 7 At this Emergency Preparedness survey, First-Rate Caregivers Health LLC was found to be out of compliance with Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers and Suppliers, 42 CFR 484.102. QR by Area 3 on 6/19/2025.

Names and Contact Information CFR(s): 484.102(c)(1) §403.748(c)(1), §416.54(c)(1), §418.113(c)(1), §441.184(c)(1), §460.84(c)(1), §482.15(c)(1), §483.73(c)(1), §483.475(c)(1), §484.102(c)(1), §485.68(c)(1), §485.542(c)(1), §485.625(c)(1), §485.727(c)(1), §485.920(c)(1), §486.360(c)(1), §491.12(c)(1), §494.62(c)(1). [(c) The [facility must develop and maintain an emergency preparedness communication plan that complies with Federal, State and local laws and must be reviewed and updated at least every 2 years [annually for LTC facilities]. The communication plan must include all of the following:] (1) Names and contact information for the following: (i) Staff. (ii) Entities providing services under arrangement. (iii) Patients' physicians (iv) Other [facilities]. (v) Volunteers. *[For Hospitals at §482.15(c) and CAHs at §485.625(c)] The communication plan must include all of the following: (1) Names and contact information for the following: (i) Staff. (ii) Entities providing services under arrangement. (iii) Patients' physicians (iv) Other [hospitals and CAHs]. (v) Volunteers. *[For RNHCIs at §403.748(c):] The communication plan must include all of the following: (1) Names and contact information for the following: (i) Staff. (ii) Entities providing services under arrangement. (iii) Next of kin, guardian, or custodian. (iv) Other RNHCIs. (v) Volunteers. *[For ASCs at §416.45(c):] The communication plan must include all of the following: (1) Names and contact information for the following: (i) Staff. (ii) Entities providing services under arrangement. (iii) Patients' physicians. (iv) Volunteers. *[For Hospices at §418.113(c):] The communication plan must include all of the following: (1) Names and contact information for the following: (i) Hospice employees. (ii) Entities providing services under arrangement. (iii) Patients' physicians. (iv) Other hospices. *[For HHAs at §484.102(c):] The communication plan must include all of the following: (1) Names and contact information for the following: (i) Staff. (ii) Entities providing services under arrangement. (iii) Patients' physicians. (iv) Volunteers. *[For OPOs at §486.360(c):] The communication plan must include all of the following: (2) Names and contact information for the following: (i) Staff. (ii) Entities providing services under arrangement. (iii) Volunteers. (iv) Other OPOs. (v) Transplant and donor hospitals in the OPO's Donation Service Area (DSA). This STANDARD is not met as evidenced by: Based on record review and interview the agency failed to ensure patient contact, physician contact, and staff emergency contact information was included in the Emergency Preparedness communication plan, for 1 of 1 home health agency. Findings include: 1. A review of an agency policy titled 'Communication Plan for Emergency Preparedness' stated, "… The Communication Plan must include the following: … iii. Client's physicians … 2. The current, updated emergency organizational chart (telephone tree) will clearly identify … client's physician … 5. The agency will maintain a staff notification tree which will … include: a. The staff member's … home address and an alternate means of communication (i.e., emergency contact information) … 11. A current roster with contact information for clients and their emergency contact will be maintained …" 2. A review of the agency's Emergency Preparedness binder failed to evidence current patients contact information, patients' physicians contact information, and staff emergency contact information. 3. On 6/12/2025 at 11:46 AM during an interview, the Administrator confirmed there was not a list of the agency's patients, their corresponding physicians, or for staff emergency contacts in the agency's Emergency Preparedness Program or binder.

This visit was for a Federal Medicaid and State Licensure survey of a home health agency. Survey dates: 06/10/2025, 06/11/2025, and 06/12/2025 Facility Number: 018849 Active Census: 7 During this Federal Initial Survey, First-Rate Caregivers Health LLC was found to be in compliance with 42 CFR 484 and out of compliance with 410 IAC 17 for a home health survey. QR by Area 3 on 6/19/2025.