S&C QCOR HHA 2567s
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HHAs 2567s
Selection Criteria ▸

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
▼ 497765 Affinity Care Plus, Inc. 3324 Virginia Beach Blvd Suite 107 Virginia Beach VA 3 (Philadelphia) 09/22/2020 C0VI11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0682 Infection Prevention Standard
G0434 Participate in care Element
G0436 Receive all services in plan of care Element
▼ 497784 Home Sweet Home Health Services Llc 195 Keith Street, Suite 2a Warrenton VA 3 (Philadelphia) 01/29/2025 65286-H1 Complaint, 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
E0004 Develop EP Plan, Review and Update Annually Standard
E0006 Plan Based on All Hazards Risk Assessment Standard
E0013 Development of EP Policies and Procedures Standard
E0021 HHA- Procedures for Follow up Staff/Pts. Standard
E0030 Names and Contact Information Standard
E0036 EP Training and Testing Standard
E0037 EP Training Program Standard
E0039 EP Testing Requirements Standard
G0572 Plan of care Standard
G0642 Program scope Standard
G0646 Program activities Standard
G0654 Track adverse patient events Standard
G0658 Performance improvement projects Standard
G0660 Executive responsibilities for QAPI Standard
G0684 Infection control Standard
G0536 A review of all current medications Element
G0616 Patient medication schedule/instructions Element
G0656 Improvements are sustained Element
▼ 507004 Cp Sound Wa, Llc 4200 6th Ave Se Ste 201 Lacey WA 10 (Seattle) 08/08/2024 63CBE-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0374 Accuracy of encoded OASIS data Standard
G0572 Plan of care Standard
G0434 Participate in care Element
G0608 Coordinate care delivery Element
G0614 Visit schedule Element
G0706 Interdisciplinary assessment of the patient Element
▼ 507004 Cp Sound Wa, Llc 4200 6th Ave Se Ste 201 Lacey WA 10 (Seattle) 10/14/2021 85F411 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0860 Licensing Standard
G0434 Participate in care Element
G0514 RN performs assessment Element
G0584 Verbal orders Element
G0608 Coordinate care delivery Element
▼ 507007 Kaiser Foundation Health Plan Of Washington 201 16th Ave E Seattle WA 10 (Seattle) 01/16/2024 61C5D-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0374 Accuracy of encoded OASIS data Standard
G0572 Plan of care Standard
G0684 Infection control Standard
G0860 Licensing Standard
G0434 Participate in care Element
G0514 RN performs assessment Element
G0530 Strengths, goals, and care preferences Element
G0574 Plan of care must include the following Element
G0656 Improvements are sustained Element
G0764 HH aide training program topics Element
G0812 Direct observation every 12 months Element
▼ 507007 Kaiser Foundation Health Plan Of Washington 201 16th Ave E Seattle WA 10 (Seattle) 09/17/2021 ZYXS11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0860 Licensing Standard
G0434 Participate in care Element
G0514 RN performs assessment Element
▼ 507010 Tri-Cities Home Health, Llc 8819 Wvictoria Avenue, Ste 110 Kennewick WA 10 (Seattle) 08/15/2025 1D1F8E-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0684 Infection control Standard
▼ 507010 Tri-Cities Home Health, Llc 8819 Wvictoria Avenue, Ste 110 Kennewick WA 10 (Seattle) 11/29/2022 5E089-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0374 Accuracy of encoded OASIS data Standard
G0572 Plan of care Standard
G0684 Infection control Standard
G0860 Licensing Standard
G0436 Receive all services in plan of care Element
G0514 RN performs assessment Element
G1022 Discharge and transfer summaries Element
▼ 507010 Tri-Cities Home Health, Llc 8819 Wvictoria Avenue, Ste 110 Kennewick WA 10 (Seattle) 11/07/2019 WYEO11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0860 Licensing Standard
G0514 RN performs assessment Element
▼ 507019 Cp Spokane Wa Hh, Llc 1000 N Argonne Rd Spokane Valley WA 10 (Seattle) 03/19/2026 1E47BE-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0952 Ensure that HHA employs qualified personnel Element