Every finding on record at Kmg Homecare Unlimited, LLC

An Emergency Preparedness Survey was conducted by the Indiana Department of Health in accordance with 42 CFR 42 CFR 484.102. Survey Dates: May 13, 14, and 15, 2025 Active Census: 91 At this Emergency Preparedness survey, KMG Homecare Unlimited was found in compliance with Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers and Suppliers, 42 CFR 42 CFR 484.102.

This visit was for a Federal Recertification survey of a Home Health Provider. Survey Dates: May 13, 14, and 15, 2025 12-Month Unduplicated Skilled Admissions: 0 Abbreviations: HHA Home Health Aide CM Clinical Manager

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 home health agency failed to ensure staff followed infection control policies and procedures related to hand hygiene for 2 of 3 home visit observations (HHA 1, HHA 3). Findings include: 1. Review of the hand hygiene policy, undated, included but not limited to “… Hand Hygiene should be performed… After contact with the patient or objects in the immediate vicinity of the patient… moving from a contaminated body site to a clean body site during patient care… After removal of personal protective equipment… Hand Hygiene refers to both handwashing with either plain or antiseptic containing soap and water, and use of alcohol-based products that do not require the use of water…” 2. Review of the Hand Washing policy, undated, included but not limited to “… Non-Surgical Hand Hygiene Technique… Alcohol-based hand rub… Apply product to palm of one hand… Rub hands together, covering all surfaces of hands and fingers… Continue to rub together until hands are dry… the use of gloves does not eliminate the need for hand hygiene…” 3. During a home visit observation on 05/14/2025 at 7:59 AM, HHA 1 performed personal care for Patient #3. HHA 1 cleaned Patient #3’s perinanal area with wipes due to stool. HHA 1 doffed gloves and rubbed hands together with alcohol-based hand sanitizer for two seconds then dried his hands with a paper towel before donning new gloves. HHA 1 finished cleaning the Patient’s perianal area and doffed his gloves. He then rubbed his hands together with alcohol-based hand sanitizer for three seconds then dried his hands with a paper towel before donning new gloves. After HHA 1 transferred Patient #3 to the wheeled shower chair and strapped the Patient in, HHA 1 doffed his gloves, rubbed his hands together with alcohol-based hand sanitizer for two seconds, dried his hands with a paper towel, and donned new gloves. HHA 1 wheeled Patient #3 into the shower. HHA 1 doffed his gloves, rubbed his hands together with alcohol-based hand sanitizer for three seconds, and then dried his hands with a paper towel before donning new gloves four times during Patient #3’s shower. HHA 1 failed to rub his hands together with the alcohol-based hand sanitizer until they were dry. During an interview on 05/14/2025 at 9:14 AM, HHA 1 indicated he doesn’t normally use paper towel to dry his hands after using alcohol-based hand sanitizer if his hands felt dry, but he would use a paper towel if his hands were not dry after using the alcohol-based hand sanitizer so he could get his gloves on. During an interview on 05/15/2025 at 12:16 PM, the CM indicated the procedure for using alcohol-based hand sanitizer was to put on the sanitizer and rub the hands together including between fingers and all surfaces of the hand at least until dry. The CM further indicated staff should only use a paper towel to dry their hands after the use of alcohol-based hand sanitizer if their hands were profusely sweaty so they could get their gloves on. 4. During a home visit observation on 05/14/2025 at 4:00 PM, HHA 3 performed personal care for Patient #4. After shampooing and applying conditioner to Patient #4’s hair, HHA 3 doffed her gloves and then donned new gloves without first performing hand hygiene. HHA 3 gave Patient #4 a washcloth to wash their face and again changed her gloves without hand hygiene after glove removal. HHA 3 reminded Patient #4 to clean their private area and instructed the Patient to put the washcloth in the hamper next to the shower. HHA 3 then doffed her gloves, dried her hands with a paper towel, and donned new gloves without performing hand hygiene after glove removal. HHA 3 assisted Patient #4 with towel drying. HHA 3 doffed her gloves, dried her hands with a paper towel, and donned new gloves without performing hand hygiene after glove removal. During an interview on 05/14/2025 at 4:34 PM, HHA indicated hand hygiene should be performed between glove changes. During an interview on 05/15/2025 at 12:18 PM, the CM indicated the agency’s procedure for glove changes included take gloves off, wash or sanitize hands, and put on new gloves. 410 IAC 17-12-1(m)

This visit was for a Federal Recertification, State Re-licensure, and a Federal and State Complaint Survey of a Home Health provider. Complaint: IN00328163, Unsubstantiated, Lack of sufficient evidence. Survey Dates: 6-16 and 6-17-2022 Census: 98 QR: Area 2 June 21, 2022

A review of all current medications CFR(s): 484.55(c)(5) A review of all medications the patient is currently using in order to identify any potential adverse effects and drug reactions, including ineffective drug therapy, significant side effects, significant drug interactions, duplicate drug therapy, and noncompliance with drug therapy. This ELEMENT is not met as evidenced by: Based on observation and interview, the agency failed to ensure the skilled nurse completed all aspects of the medication reconciliation and for 1 of 1 home visit observation of a registered nurse (registered nurse #4). Findings include: 1. On 6-17-22 at 9:27 AM during a home visit observation, the plan of care for the certification period 04-26-22 to 06-24-22 was used to reconcile the medications for Patient #6. The following medications were present but were not included on the medication list nor reconciled: Glucosamine (anti-inflammatory), 1 tab by mouth every day. An over the counter medication. Fenofibrinate (cholesterol medication), 160 mg by mouth every day, prescribed on 4-25-22. Escitalopram (Lexepro- antidepressant), 10 mg by mouth every day, prescribed on 4-04-22. Nitrofurantoin (Macrodantin- Urinary tract infection), 100 mg by mouth every day, prescribed on 4-15-22. 2. On 6-17-22 at 9:40 AM, the Registered Nurse (RN), Employee # 4, was queried about the medication reconciliation process. Employee #4 indicated the medications are reviewed prior to each recertification period. A review of the clinical records indicated supervisory visits with a recertification were completed on 4-18-22 and 5-16-22. Employee #4 indicated they were not certain the medications in question were current medications. 3. On 6-17-22 at 9:40 AM, the Home Health Aide (HHA), Employee #4, was queried about the medications on Patient #6's table. Employee #4 indicated that Patient #6 did take the medications, but not every day and relayed, "I can't get her to take them all." 4. On 6-17-22 at 2:00 PM, the Director of Nursing (DON), Employee #2, was queried about the medication reconciliation process. Employee #2 indicated all meds should be reviewed and accounted for with each recertification. 410 IAC 17-14-1-(a)(1)(B)