S&C QCOR HHA 2567s
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HHAs 2567s
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Time Interval

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Provider Characteristics

Use these filters if you want to limit the report to providers that have certain characteristics. To select more than one option, hold down the Ctrl (individual point-and-click) OR Shift keys (select through a range) while you click on the additional desired option(s).

Survey Type & Deficiency Tags

Use these filters if you want to limit the reports to providers on specific survey types, or to reports that were cited for specific HHA deficiency tags and tag types. To select more than one option, hold down the Ctrl (individual point-and-click) OR Shift keys (select through a range) while you click on the additional desired option(s).

CCN and Facility Name

Use these filters if you know the name (or partial name) of the facility you are searching for, or the CMS Certification Number (CCN) for the facility you are searching for.

Other Survey Characteristics

Select one of the options below to filter by surveys that cite deficiencies or by surveys that are deficiency-free. By default, only surveys that cite deficiencies are displayed. Selecting "All" displays all surveys.

CMS Certification Number Facility Name Address City State CMS Region Date of CMS Survey Survey Event ID Survey Type Statement of Deficiencies Report
▼ 059227 Valley Medical Systems, Inc. 2511 West Shaw Avenue Suite 101 Fresno CA 9 (San Francisco) 01/28/2019 3ZRV11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0642 Program scope Standard
G0418 Patient's or legal representative's signature Element
G0514 RN performs assessment Element
G0520 5 calendar days after start of care Element
G0706 Interdisciplinary assessment of the patient Element
G0726 Nursing services supervised by RN Element
G0968 Assure implementation of plan of care Element
▼ 059247 In Home Healthcare, Inc 1280 E Cooley Dr Colton CA 9 (San Francisco) 04/07/2022 38760-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0004 Develop EP Plan, Review and Update Annually Standard
E0019 Homebound HHA/Hospice Inform EP Officials Standard
E0032 Primary/Alternate Means for Communication Standard
E0037 EP Training Program Standard
G0372 Encoding and transmitting OASIS Standard
G0687 COVID-19 Vaccination of Home Health Agency staff Standard
G0444 State toll free HH telephone hotline Element
G0536 A review of all current medications Element
G0550 At discharge Element
▼ 059247 In Home Healthcare, Inc 1280 E Cooley Dr Colton CA 9 (San Francisco) 09/13/2019 3VRP11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0001 Establishment of the Emergency Program (EP) Condition
G0640 Quality assessment/performance improvement Condition
G0680 Infection prevention and control Condition
E0006 Plan Based on All Hazards Risk Assessment Standard
E0009 Local, State, Tribal Collaboration Process Standard
E0019 Homebound HHA/Hospice Inform EP Officials Standard
E0031 Emergency Officials Contact Information Standard
E0032 Primary/Alternate Means for Communication Standard
E0034 Information on Occupancy/Needs Standard
E0037 EP Training Program Standard
E0039 EP Testing Requirements Standard
G0642 Program scope Standard
G0644 Program data Standard
G0658 Performance improvement projects Standard
G0660 Executive responsibilities for QAPI Standard
G0684 Infection control Standard
G0550 At discharge Element
G0710 Provide services in the plan of care Element
▼ 059253 Metropolitan Healthcare, Inc 1007 S Central Ave Suite 200 Glendale CA 9 (San Francisco) 04/09/2023 5F5F9-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0037 EP Training Program Standard
G0572 Plan of care Standard
G0528 Health, psychosocial, functional, cognition Element
G0536 A review of all current medications Element
G0602 Communication with all physicians Element
G0610 Patients receive education and training Element
G0710 Provide services in the plan of care Element
G1012 Required items in clinical record Element
▼ 059253 Metropolitan Healthcare, Inc 1007 S Central Ave Suite 200 Glendale CA 9 (San Francisco) 02/21/2020 L8KY11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0510 Comprehensive Assessment of Patients Condition
G0460 Patient refuses services Element
G0522 Eligibility for Medicare home health benefit Element
G1022 Discharge and transfer summaries Element
▼ 059254 Rodan Home Health Services, Inc 2140 West Olympic Blvd Suite 501 Los Angeles CA 9 (San Francisco) 03/12/2023 5F3E4-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0004 Develop EP Plan, Review and Update Annually Standard
G0572 Plan of care Standard
G0536 A review of all current medications Element
G0590 Promptly alert relevant physician of changes Element
G0606 Integrate all services Element
▼ 059254 Rodan Home Health Services, Inc 2140 West Olympic Blvd Suite 501 Los Angeles CA 9 (San Francisco) 04/28/2019 XFQ111 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0544 Update of the comprehensive assessment Standard
G0572 Plan of care Standard
G0536 A review of all current medications Element
▼ 059255 Optima Health Care Services, Inc 235 East Broadway Suite 920 Long Beach CA 9 (San Francisco) 12/16/2019 JKUN11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0580 Only as ordered by a physician Element
G0590 Promptly alert relevant physician of changes Element
G0708 Development and evaluation of plan of care Element
G0710 Provide services in the plan of care Element
▼ 059259 Suncrest Home Health Services Inc 12598 Central Avenue Suite 201 Chino CA 9 (San Francisco) 05/19/2022 4EA2E-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0640 Quality assessment/performance improvement Condition
G0642 Program scope Standard
G0644 Program data Standard
G0658 Performance improvement projects Standard
G0660 Executive responsibilities for QAPI Standard
G0687 COVID-19 Vaccination of Home Health Agency staff Standard
G1024 Authentication Standard
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
▼ 059259 Suncrest Home Health Services Inc 12598 Central Avenue Suite 201 Chino CA 9 (San Francisco) 06/29/2018 7CQI11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0001 Establishment of the Emergency Program (EP) Condition
G0640 Quality assessment/performance improvement Condition
G0680 Infection prevention and control Condition
E0009 Local, State, Tribal Collaboration Process Standard
E0017 HHA Comprehensive Assessment in Disaster Standard
E0019 Homebound HHA/Hospice Inform EP Officials Standard
E0030 Names and Contact Information Standard
E0032 Primary/Alternate Means for Communication Standard
E0037 EP Training Program Standard
G0642 Program scope Standard
G0644 Program data Standard
G0658 Performance improvement projects Standard
G0660 Executive responsibilities for QAPI Standard
G0684 Infection control Standard
G0536 A review of all current medications Element
G0648 High risk, high volume, or problem-prone area Element
G0650 Incidence, prevalence, severity of problems Element