Department of Health & Human Services

Centers for Medicare & Medicaid Services
Form Approved

OMB No. 0938-0391

Statement of Deficiencies (X1) Provider/Supplier/CLIA Identification Number 017037 (X3) Date Survey Completed 11/21/2019
Name of Provider or Supplier Alabama Homecare Of Montgomery, Llc Street Address, City, State 400 South Union Street Suite 285, Montgomery, AL
For information on the provider's plan to correct this deficiency, please contact the provider or the state survey agency.
(X4) ID Prefix Tag Summary Statement of Deficiencies

(Each deficiency should be preceded by full regulatory or LSC identifying information)
E0000 Based on the recertification survey conducted on 11/19/19 to 11/21/19, the agency was found to be in substantial compliance with the Conditions of Participation for Emergency Preparedness.