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
▼ 497724 Prima Home Health Inc 14101 Willard Road Suite C Chantilly VA 3 (Philadelphia) 01/24/2019 PB1Z11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0009 Local, State, Tribal Collaboration Process Standard
E0021 HHA- Procedures for Follow up Staff/Pts. Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0031 Emergency Officials Contact Information Standard
E0036 EP Training and Testing Standard
G0578 Conformance with physician orders Standard
G0412 Written notice of patient's rights Element
G0414 HHA administrator contact information Element
G0446 Contact info Federal/State-funded entities Element
G0546 Last 5 days of every 60 days unless: Element
G0574 Plan of care must include the following Element
G0592 Revised plan of care Element
▼ 497733 Warm Hearth At Home Inc 100 Arbor Drive Suite 108 Christiansburg VA 3 (Philadelphia) 02/14/2024 62425-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0430 Be free from abuse Element
G0800 Services provided by HH aide Element
▼ 497736 Friends Health Care Team, Inc. 8003 Forbes Pl Ste 101 Springfield VA 3 (Philadelphia) 09/13/2022 4F5F1-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
E0017 HHA Comprehensive Assessment in Disaster Standard
E0037 EP Training Program Standard
E0039 EP Testing Requirements Standard
▼ 497736 Friends Health Care Team, Inc. 8003 Forbes Pl Ste 101 Springfield VA 3 (Philadelphia) 09/10/2019 L1T711 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0006 Plan Based on All Hazards Risk Assessment Standard
E0009 Local, State, Tribal Collaboration Process Standard
E0019 Homebound HHA/Hospice Inform EP Officials Standard
E0021 HHA- Procedures for Follow up Staff/Pts. Standard
E0023 Policies/Procedures for Medical Documentation Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0030 Names and Contact Information Standard
E0031 Emergency Officials Contact Information Standard
E0032 Primary/Alternate Means for Communication Standard
E0034 Information on Occupancy/Needs Standard
E0036 EP Training and Testing Standard
E0037 EP Training Program Standard
E0039 EP Testing Requirements Standard
G0572 Plan of care Standard
G0434 Participate in care Element
G0440 Payment from federally funded programs Element
G0446 Contact info Federal/State-funded entities Element
G0574 Plan of care must include the following Element
G0580 Only as ordered by a physician Element
G1022 Discharge and transfer summaries Element
▼ 497736 Friends Health Care Team, Inc. 8003 Forbes Pl Ste 101 Springfield VA 3 (Philadelphia) 06/13/2018 I04C11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0774 12 hours inservice every 12 months Standard
G0800 Services provided by HH aide Element
G0814 Non-skilled direct observation every 60 days Element
▼ 497742 Hunt Country Health Services 31 S Braddock St, Suite 109 Winchester VA 3 (Philadelphia) 03/29/2018 QTSR11 Complaint
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
G0406 Patient rights Condition
G0940 Organization and administration of services Condition
E0004 Develop EP Plan, Review and Update Annually Standard
E0006 Plan Based on All Hazards Risk Assessment Standard
E0007 EP Program Patient Population Standard
E0009 Local, State, Tribal Collaboration Process Standard
E0013 Development of EP Policies and Procedures Standard
E0019 Homebound HHA/Hospice Inform EP Officials Standard
E0021 HHA- Procedures for Follow up Staff/Pts. Standard
E0023 Policies/Procedures for Medical Documentation Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0030 Names and Contact Information Standard
E0032 Primary/Alternate Means for Communication Standard
E0033 Methods for Sharing Information Standard
E0034 Information on Occupancy/Needs Standard
E0036 EP Training and Testing Standard
E0037 EP Training Program Standard
E0039 EP Testing Requirements Standard
G0572 Plan of care Standard
G0828 Medicaid personal care aide-only services Standard
G0970 Parent-branch relationship Standard
G1026 Retention of records Standard
G1028 Protection of records Standard
G0412 Written notice of patient's rights Element
G0414 HHA administrator contact information Element
G0434 Participate in care Element
G0436 Receive all services in plan of care Element
G0438 Have a confidential clinical record Element
G0440 Payment from federally funded programs Element
G0444 State toll free HH telephone hotline Element
G0446 Contact info Federal/State-funded entities Element
G0484 Document complaint and resolution Element
G0946 Administrator appointed by governing body Element
G0952 Ensure that HHA employs qualified personnel Element
G1012 Required items in clinical record Element
▼ 497751 Healing Home Healthcare Inc 7000 Infantry Ridge Road, Suite 110 Manassas VA 3 (Philadelphia) 08/27/2024 63F7F-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0442 Written notice for non-covered care Element
▼ 497751 Healing Home Healthcare Inc 7000 Infantry Ridge Road, Suite 110 Manassas VA 3 (Philadelphia) 09/04/2019 2F2W11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0600 Coordination of Care Standard
G1024 Authentication Standard
G0484 Document complaint and resolution Element
G0590 Promptly alert relevant physician of changes Element
G0952 Ensure that HHA employs qualified personnel Element
G1022 Discharge and transfer summaries Element
▼ 497752 Avalon In Home Nursing And Rehabilitation Llc 6402 Arlington Blvd., Ste 720 Falls Church VA 3 (Philadelphia) 10/29/2024 64817-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0430 Be free from abuse Element
G0984 In accordance with current clinical practice Element
▼ 497752 Avalon In Home Nursing And Rehabilitation Llc 6402 Arlington Blvd., Ste 720 Falls Church VA 3 (Philadelphia) 09/21/2022 4F649-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
G0434 Participate in care Element
G0440 Payment from federally funded programs Element
G0574 Plan of care must include the following Element