Every finding on record at Nit Home Health & Therapy LLC

AMENDED after IDR and CMS review As directed by the Centers for Medicare and Medicaid Services (CMS) Kansas City Location, the Department of Inspections, Appeals and Licensing conducted a complaint survey for complaint #2564840-C from 8/18/25 to 8/20/25. The complaint survey identified the following: Condition of Participation 42 CFR 484.105 Organization and Administration of Services, was investigated and no condition level deficiency or standard level deficiency was identified. The agency reported a current census of 49 patients at the time of the survey.

Organization and administration of services CFR(s): 484.105 Condition of participation: Organization and administration of services. The HHA must organize, manage, and administer its resources to attain and maintain the highest practicable functional capacity, including providing optimal care to achieve the goals and outcomes identified in the patient's plan of care, for each patient's medical, nursing, and rehabilitative needs. The HHA must assure that administrative and supervisory functions are not delegated to another agency or organization, and all services not furnished directly are monitored and controlled. The HHA must set forth, in writing, its organizational structure, including lines of authority, and services furnished. This CONDITION is not met as evidenced by: Based on staff interview, surveyor observation and record review the home health agency failed to: ensure the home health agency received approval to switch the parent office location to a branch office location (G972). The cumulative effects of these systemic practices resulted in the failure to ensure the organizational framework of the agency promoted and protected the rights of the agency's patients.

Report all branch locations to SA CFR(s): 484.105(d)(1) The parent HHA is responsible for reporting all branch locations of the HHA to the state survey agency at the time of the HHA's request for initial certification, at each survey, and at the time the parent proposes to add or delete a branch. This ELEMENT is not met as evidenced by: Based on staff interviews and agency document review, the agency failed to obtain approval to switch the parent office location to a branch office location. Failure to obtain approval of the branch location placed agency patients at risk of inappropriate and unsafe care. Findings include: On 8/18/25 at 12:30 PM the surveyor entered the office located at 217 E Bremer Ave, Waverly, IA. The surveyor observed the office to be staffed and operational. Front desk personnel, called Staff B, Quality Coordinator, from the upper level. Staff B, Quality Coordinator, came down and escorted surveyor upstairs to the home health office area. The home health area consisted of a room with a desk that Staff B used, another room to the left with a desk and computer that the surveyor was instructed to use and a third room to the right that appeared to be used for storage. Interview on 8/18/25 at 12:40 PM with Staff C, VP of Clinical Services for Iowa, reported the agency purchased the agency and took over the services from the previous home health agency. At this time the parent office and branch office switched locations. The parent office is now located in West Des Moines. The branch office is located in Waverly. On 8/18/25 at 12:50 PM, Staff B, Quality Coordinator reported the agency bought the previous home health agency in September 2024. The agency currently did not have any patients out of Waverly office and had not provided services to any patients out of the Waverly office since the current agency bought the home health agency. Interview on 8/19/25 at 4:13 PM with Staff A, Administrator, when surveyor requested information on the Waverly branch office, Staff A replied, " it is not a branch office, we provide no services out of it." Staff B, Quality Coordinator, just sits up there in case someone comes in. Staff A, Administrator reported no services are provided out of the Waverly office. Staff A, Administrator contacted Staff D, Sr VP of Strategy, regarding request for additional information or Celerian Group Company (CGS) letter regarding Waverly branch office. The agency provided the surveyor with the following document: Letter of intent, dated 9/4/24,previous home health owner sent letter of intent to SA Program Coordinator, identified agency desire to swap locations of the current parent and branch office locations. a. Current parent location 217 E Bremer Ave, Ste D, Waverly, IA 50677 and Branch location 10861 Douglas Ave, Ste A, Urbandale, IA 50322. b. The requested change would be parent office location at 10861 Douglas Ave, Ste A, Urbandale, IA 50322 and branch office location at 217 E Bremer Ave, Ste D, Waverly, IA 50677. Interview on 8/20/25 at 9:02 AM with Staff D, Sr VP of Strategy, reported he did not have a Celerian Group Company (CGS) approval letter for the branch office at the Waverly location, but he did receive a CGS approval letter for the parent office in Urbandale. Staff D reported he did not look that closely to the CGS letter to identify the branch location was not listed. Staff D, reported the agency worked with a lawyer to ensure paperwork was completed regarding the agency change, there was lots of information and communication back and forth and he thought everything was done correctly. Staff D would look for additional correspondence to verify the branch office approval and forward information to surveyor. No further documentation for the branch approval was provided to the surveyor prior to the end of the survey. The agency failed to obtain approval of the branch location in Waverly, Iowa. The above findings were reviewed with the Administrator.