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
▼ 497040 Virginia In-Home Partner-Viii Llc 104 Cranberry Rd Ste 100b Galax VA 3 (Philadelphia) 09/01/2021 F8W811 Focused Infection Control, Other-Fed, Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
▼ 497040 Virginia In-Home Partner-Viii Llc 104 Cranberry Rd Ste 100b Galax VA 3 (Philadelphia) 03/22/2018 WPAF11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0612 Written instructions to patient include: Standard
G0434 Participate in care Element
G0580 Only as ordered by a physician Element
G0590 Promptly alert relevant physician of changes Element
▼ 497044 Home Nursing Services Of Southwest Va, Inc 26104 Lee Highway Abingdon VA 3 (Philadelphia) 06/30/2021 2GU811 Focused Infection Control, Other-Fed, Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0574 Plan of care must include the following Element
G0580 Only as ordered by a physician Element
▼ 497044 Home Nursing Services Of Southwest Va, Inc 26104 Lee Highway Abingdon VA 3 (Philadelphia) 07/25/2018 6YL111 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0574 Plan of care must include the following Element
G0818 HH aide supervision elements Element
▼ 497055 Southside Community Hospital, Inc. 1705 East 3rd Street Farmville VA 3 (Philadelphia) 10/26/2021 WOGP11 Focused Infection Control, Other-Fed, Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
▼ 497055 Southside Community Hospital, Inc. 1705 East 3rd Street Farmville VA 3 (Philadelphia) 06/27/2018 GDLM11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
▼ 497058 Winchester Medical Center Home Health Agency 333 West Cork Street Suite 135 Winchester VA 3 (Philadelphia) 07/20/2018 5TVQ11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0017 HHA Comprehensive Assessment in Disaster Standard
E0021 HHA- Procedures for Follow up Staff/Pts. Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0030 Names and Contact Information Standard
G0544 Update of the comprehensive assessment Standard
G0572 Plan of care Standard
G0586 Review and revision of the plan of care Standard
G0682 Infection Prevention Standard
G0422 Written notice within 4 business days Element
G0536 A review of all current medications Element
G0606 Integrate all services Element
G1022 Discharge and transfer summaries Element
▼ 497063 Mountain States Health Alliance 87 S Flanagan Avenue Lebanon VA 3 (Philadelphia) 10/31/2018 ZZSV11 Recertification, Sample Validation
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
▼ 497068 Mountain States Health Alliance 96 15th Street Nw Suite 104a Norton VA 3 (Philadelphia) 08/01/2018 CHXV11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0574 Plan of care must include the following Element
G0818 HH aide supervision elements Element
▼ 497072 Petersburg Home Care Services Llc 43 Rives Road, Suite 2 Petersburg VA 3 (Philadelphia) 11/10/2021 37E26-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0682 Infection Prevention Standard
G1022 Discharge and transfer summaries Element