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A W Holdings LLC

No longer in CMS list This agency is not in CMS's current list of Medicare-certified home health agencies (file dated 2026-09-21), but it has federal inspection records. It may have closed, changed ownership, or changed its certification number. Address shown is from its inspection records.
5620 Industrial Road, Fort Wayne, IN 46825
CMS Certification Number 15K034
17deficiencies since 2018
0serious
3inspections
n/aCMS quality stars
Data from CMS inspection reports (Form 2567), 2018-01-02 to 2026-10-15, downloaded 2026-10-21; CMS agency list file dated 2026-09-21. What the labels mean

Inspection 2024-12-04

· Recertification · 9 deficiencies · CMS source report (PDF)
Moderate Infection Prevention

The home health agency failed to ensure all staff followed standard precautions and agency policies/procedures for 2 of 3 home visit observations (Patients #2, 3).

Source: CMS Form 2567, inspection 2024-12-04, tag G0682 · view on CMS
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Moderate Infection Control Education

The home health agency failed to re-educate staff when a breach in infection control procedures was reported for 1 of 1 record reviewed of a patient with a central line (Patient #2).

Source: CMS Form 2567, inspection 2024-12-04, tag G0686 · view on CMS
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Minor Rn Performs Assessment

The home health agency failed to evidence documentation of an initial assessment visit for 2 of 3 active records reviewed of patients admitted in 2024 (Patients #2, #4).

Source: CMS Form 2567, inspection 2024-12-04, tag G0514 · view on CMS
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Minor At Discharge

The home health agency failed to evidence documentation of the discharge comprehensive assessment for 1 of 1 closed record review of a patient discharged due to caregiver request (Patient #6).

Source: CMS Form 2567, inspection 2024-12-04, tag G0550 · view on CMS
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Minor Plan Of Care Must Include The Following

The home health agency failed to ensure the plan of care included all patient-specific interventions, for 5 of 5 complete active records reviewed (Patients #1, 2, 3, 4, 5).

Source: CMS Form 2567, inspection 2024-12-04, tag G0574 · view on CMS
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Minor Only As Ordered By A Physician

The home health agency failed to ensure all care and services were provided according to physician orders for 2 of 5 active records reviewed (Patient #2, 5).

Source: CMS Form 2567, inspection 2024-12-04, tag G0580 · view on CMS
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Minor Promptly Alert Relevant Physician Of Changes

The home health agency failed to promptly alert the physician of changes in the patient’s condition for 2 of 2 active records reviewed which evidenced a change in patient condition (Patients #1, 2) and failed to notify the physician of its inability to provide services as ordered for 1 of 4 active…

Source: CMS Form 2567, inspection 2024-12-04, tag G0590 · view on CMS
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Minor Integrate All Services

The home health agency failed to coordinate care with all outside entities providing home health services to 1 of 1 active record reviewed of a patient receiving home health services from an outside entity (Patient #2).

Source: CMS Form 2567, inspection 2024-12-04, tag G0606 · view on CMS
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Minor Hh Aide Supervision Elements

The home health agency failed to supervise all HHAs to ensure the aide completed all tasks according to the aide care plan for 1 of 1 complete active record review of a patient receiving HHA services (Patient #4).

Source: CMS Form 2567, inspection 2024-12-04, tag G0818 · view on CMS
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Inspection 2022-02-25

· Complaint, Recertification · 4 deficiencies · CMS source report (PDF)
Moderate Conformance With Physician Orders

The agency failed to ensure all physician orders were executed in 1 of 5 active records reviewed (Patient #2).

Source: CMS Form 2567, inspection 2022-02-25, tag G0578 · view on CMS
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Minor A Review Of All Current Medications

The agency failed to ensure a drug interaction review completed included all medications listed on the plan of care, for 1 of 5 active records reviewed (#7).

Source: CMS Form 2567, inspection 2022-02-25, tag G0536 · view on CMS
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Minor Interdisciplinary Assessment Of The Patient

The skilled nurse failed to ensure the comprehensive assessment included a complete cardiopulmonary assessment in 1 of 5 active records reviewed (Patient #2).

Source: CMS Form 2567, inspection 2022-02-25, tag G0706 · view on CMS
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Minor Required Items In Clinical Record

The agency failed to follow their policy and ensure all visit notes were received by the agency office within 7 days for 2 of 5 active records reviewed (Patients #1 and 7).

Source: CMS Form 2567, inspection 2022-02-25, tag G1012 · view on CMS
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Inspection 2019-05-23

· Recertification · 4 deficiencies · CMS source report (PDF)
Moderate Plan Of Care

The agency failed to ensure the plan of care was followed for the ordered frequency/ duration of services and failed to ensure frequency of visits were not broad and specific to the patient's needs in 1 of 8 clinical records reviewed (#1).

Source: CMS Form 2567, inspection 2019-05-23, tag G0572 · view on CMS
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Moderate Infection Prevention

The agency failed to ensure staff followed infection control policies and procedures for 1 of 3 home visit observations (patient # 8).

Source: CMS Form 2567, inspection 2019-05-23, tag G0682 · view on CMS
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Minor Plan Of Care Must Include The Following

The agency failed to ensure all durable medical equipment used by the patient was included on the individualized plan of care for 1 of 8 records reviewed.

Source: CMS Form 2567, inspection 2019-05-23, tag G0574 · view on CMS
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Minor Only As Ordered By A Physician

The agency failed to ensure extra nursing visits were provided only as ordered by the physician for 1 of 8 records reviewed.

Source: CMS Form 2567, inspection 2019-05-23, tag G0580 · view on CMS
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