At least 7 of the 10 required patients should be receiving care from the home health agency at the time of the initial Medicare survey. 1  If no deficiencies are issued at the time of the initial certification survey, MDH will recommend Medicare certification to Region V Office of CMS effective the date of the survey.
Today, some call these old road signs Indian marker trees. They are known by others as trail trees, thong trees, or culturally modified trees. Years ago, Linda Pelon, one of the first anthropologists researching the subject, taught me the term of Indian marker tree.
Many Native American Indians expressed themselves with their artwork carved into totem poles. Many believe that all Indian tribes carved totem poles but this is far from the truth. Those Indians living in the southwest, the plains and Inuit Indians did not have trees to carve.