New Horizons Home Health Services

“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 and interview, the agency failed to ensure proper infection control practices related to bag technique and clean and dirty areas of a barrier for 1 of 3 home observations of SN care (Patient #3). Findings include: 410 IAC 17-12-1(m) During a home visit observation on 03/19/2026 beginning at 03:02 PM, LPN 1had a small barrier on the table. LPN 1’s bag was on the barrier and took up most of the barrier. After LPN 1 washed her hands, she removed assessment equipment from the bag and placed it at the edge of the barrier. LPN 1 charted each vital sign on her phone immediately after she checked each vital sign. LPN 1 then placed the phone next to the barrier. As LPN 1 finished using each piece of equipment, she placed it on the edge of the barrier, on the dirty side of the barrier where it touched the nursing bag. LPN 1 cleaned each piece of equipment with a disinfecting wipe and placed the equipment in the nursing bag. LPN 1 failed to follow accepted infection control practices to limit the risk of cross contamination. During an interview after the SN visit, LPN 1 indicated she did not know if the nursing bag was clean or dirty. LPN 1 indicated the phone was clean as she disinfected it prior to beginning the assessment. LPN 1 indicated she placed it next to the barrier after each use. LPN 1 indicated the clean equipment dried in the nursing bag. LPN 1 stated that the reusable barrier was too small to adequately hold the nursing bag while also maintaining separate clean and dirty sections.”

“Competency evaluation CFR(s): 484.80(c)(1)(2)(3) Standard: Competency evaluation. An individual may furnish home health services on behalf of an HHA only after that individual has successfully completed a competency evaluation program as described in this section. (1) The competency evaluation must address each of the subjects listed in paragraph (b)(3) of this section. Subject areas specified under paragraphs (b)(3)(i), (iii), (ix), (x), and (xi) of this section must be evaluated by observing an aide’s performance of the task with a patient or pseudo-patient. The remaining subject areas may be evaluated through written examination, oral examination, or after observation of a home health aide with a patient, or with a pseudo-patient as part of a simulation. (2) A home health aide competency evaluation program may be offered by any organization, except as specified in paragraph (f) of this section. (3) The competency evaluation must be performed by a registered nurse in consultation with other skilled professionals, as appropriate. This Standard is not met as evidenced by: Based on record review and interview, the agency failed to identify the method used to evaluate HHA skills competency for 2 of 4 HHA personnel records reviewed (HHA 1 and 2). Findings include: 410 IAC 17-14-1(I)(l)(A) Review of HHA 1’s personnel record showed a competency checklist dated 08/08/2024. The checklist did not indicate whether each skill was demonstrated on a patient, a pseudo‑patient, through verbal explanation, or by written test. The agency failed to document the method of skills review. During an interview on 03/24/2026 Beginning at 10:35 AM, the Administrator stated that the competency checklist did not identify the method used to evaluate each skill. Review of HHA 2’s personnel record showed a competency checklist dated 01/31/2024. The checklist did not indicate whether each skill was demonstrated on a patient, a pseudo‑patient, through verbal explanation, or by written test. The agency failed to document the method of skills review. During an interview on 03/24/2026 beginning at 10:35 AM, the Administrator stated that the competency checklist did not identify the method used to evaluate each skill.”

“Plan of care must include the following CFR(s): 484.60(a)(2)(i-xvi) The individualized plan of care must include the following: (i) All pertinent diagnoses; (ii) The patient’s mental, psychosocial, and cognitive status; (iii) The types of services, supplies, and equipment required; (iv) The frequency and duration of visits to be made; (v) Prognosis; (vi) Rehabilitation potential; (vii) Functional limitations; (viii) Activities permitted; (ix) Nutritional requirements; (x) All medications and treatments; (xi) Safety measures to protect against injury; (xii) A description of the patient’s risk for emergency department visits and hospital re-admission, and all necessary interventions to address the underlying risk factors. (xiii) Patient and caregiver education and training to facilitate timely discharge; (xiv) Patient-specific interventions and education; measurable outcomes and goals identified by the HHA and the patient; (xv) Information related to any advanced directives; and (xvi) Any additional items the HHA or physician or allowed practitioner may choose to include. This Element is not met as evidenced by: Based on record review and interview, the agency failed to include standard POC service frequency ranges for 1 of 1 patient with a home visit observation of HHA services (Patient #4). Findings include: 410 IAC 17-13-1(a)(1)(C)(iii) The POC for certification period 03/10/2026 – 05/08/2026, documented HHA service hours as “1–14 hours per day. The POC failed identify the number of hours required per visit. Review of HHA services provided from 01/18/2026 through 03/14/2026 showed the patient received an average of 6 hours of HHA services per day. During an interview on 03/23/2026 beginning at 02:12 PM, the Administrator indicated the agency included a broad range of hours because they were unsure whether caregivers might require additional HHA support.”