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
▼ 059290 Asap Home Health Providers, Inc 68 Rio Rancho Rd Suite 201 Pomona CA 9 (San Francisco) 09/18/2019 L7QP11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G1030 Retrieval of records Standard
▼ 059300 Pacific Rim Home Health, Inc 2225 W Commonwealth Ave Suite 202 Alhambra CA 9 (San Francisco) 11/12/2021 RD94-H2 Complaint
Deficiency Tag Deficiency Description Tag Type
G0370 Reporting OASIS information Condition
G0510 Comprehensive Assessment of Patients Condition
G0570 Care planning, coordination, quality of care Condition
G0700 Skilled professional services Condition
G0374 Accuracy of encoded OASIS data Standard
G0526 Content of the comprehensive assessment Standard
G0572 Plan of care Standard
G0702 Services by skilled professionals Standard
G0532 Continuing need for home care Element
G0536 A review of all current medications Element
G0590 Promptly alert relevant physician of changes Element
▼ 059300 Pacific Rim Home Health, Inc 2225 W Commonwealth Ave Suite 202 Alhambra CA 9 (San Francisco) 10/05/2021 RD9411 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0370 Reporting OASIS information Condition
G0510 Comprehensive Assessment of Patients Condition
G0570 Care planning, coordination, quality of care Condition
G0700 Skilled professional services Condition
G0374 Accuracy of encoded OASIS data Standard
G0526 Content of the comprehensive assessment Standard
G0572 Plan of care Standard
G0702 Services by skilled professionals Standard
G0532 Continuing need for home care Element
G0536 A review of all current medications Element
G0590 Promptly alert relevant physician of changes Element
▼ 059303 Seaport Home Health 5411 Avenida Encinas Carlsbad CA 9 (San Francisco) 12/01/2022 5E5E3-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0584 Verbal orders Element
G0606 Integrate all services Element
▼ 059307 Noble Hospice & Home Health Care, Inc 6601 Owens Dr. Pleasanton CA 9 (San Francisco) 12/08/2021 38024-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0570 Care planning, coordination, quality of care Condition
G0572 Plan of care Standard
G0682 Infection Prevention Standard
G0428 Property and person treated with respect Element
G0434 Participate in care Element
G0590 Promptly alert relevant physician of changes Element
G0592 Revised plan of care Element
G0726 Nursing services supervised by RN Element
▼ 059307 Noble Hospice & Home Health Care, Inc 6601 Owens Dr. Pleasanton CA 9 (San Francisco) 01/31/2020 WZ1L11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0570 Care planning, coordination, quality of care Condition
G0578 Conformance with physician orders Standard
G0586 Review and revision of the plan of care Standard
G0774 12 hours inservice every 12 months Standard
G0590 Promptly alert relevant physician of changes Element
G0608 Coordinate care delivery Element
▼ 059308 Senior Care Outreach, Inc 43136 Christy Street, Suite 112 Fremont CA 9 (San Francisco) 01/11/2018 1KLS11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0100 PATIENT RIGHTS Condition
G0156 ACCEPTANCE OF PATIENTS, POC, MED SUPER Condition
G0235 CLINICAL RECORDS Condition
G0330 COMPREHENSIVE ASSESSMENT OF PATIENTS Condition
G0101 PATIENT RIGHTS Standard
G0109 RIGHT TO BE INFORMED AND PARTICIPATE Standard
G0110 RIGHT TO BE INFORMED AND PARTICIPATE Standard
G0111 CONFIDENTIALITY OF MEDICAL RECORDS Standard
G0159 PLAN OF CARE Standard
G0164 PERIODIC REVIEW OF PLAN OF CARE Standard
G0166 CONFORMANCE WITH PHYSICIAN ORDERS Standard
G0173 DUTIES OF THE REGISTERED NURSE Standard
G0177 DUTIES OF THE REGISTERED NURSE Standard
G0236 CLINICAL RECORDS Standard
G0321 ENCODING OASIS DATA Standard
G0332 INITIAL ASSESSMENT VISIT Standard
G0337 DRUG REGIMEN REVIEW Standard
G0341 UPDATE OF THE COMPREHENSIVE ASSESSMENT Standard
▼ 059324 Premier Healthcare Services, Llc 14724 Venutra Blvd Suite 400 Sherman Oaks CA 9 (San Francisco) 02/20/2026 1E476B-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0478 Investigate complaints made by patient Element
G0488 Immediate reporting of abuse by all staff Element
G0536 A review of all current medications Element
G0604 Integrate all orders Element
▼ 059324 Premier Healthcare Services, Llc 14724 Venutra Blvd Suite 400 Sherman Oaks CA 9 (San Francisco) 02/06/2026 1E2F6F-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0470 Document efforts to resolve problems Element
G1014 Interventions and patient response Element
▼ 059324 Premier Healthcare Services, Llc 14724 Venutra Blvd Suite 400 Sherman Oaks CA 9 (San Francisco) 10/30/2025 1DA31C-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0536 A review of all current medications Element