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
▼ 507089 Spokane Home Care Services, Llc 201 W North River Dr Ste 335 Spokane WA 10 (Seattle) 08/23/2021 JRJY11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0682 Infection Prevention Standard
G0684 Infection control Standard
G0860 Licensing Standard
G0514 RN performs assessment Element
G0580 Only as ordered by a physician Element
▼ 507092 Wesley Homes At Home 815 South 216th Street Des Moines WA 10 (Seattle) 06/29/2023 5FF97-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 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
E0013 Development of EP Policies and Procedures Standard
G0572 Plan of care Standard
G0642 Program scope Standard
G0644 Program data Standard
G0684 Infection control Standard
G0686 Infection control education Standard
G0860 Licensing Standard
G0514 RN performs assessment Element
G0710 Provide services in the plan of care Element
G1022 Discharge and transfer summaries Element
▼ 507097 Kittitas Valley Home Health & Hospice 1506 E Radio Rd Ellensburg WA 10 (Seattle) 10/12/2023 612B9-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 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
G0520 5 calendar days after start of care Element
G0808 Onsite supervisory visit every 14 days Element
▼ 507097 Kittitas Valley Home Health & Hospice 1506 E Radio Rd Ellensburg WA 10 (Seattle) 08/12/2021 RTY811 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0860 Licensing Standard
▼ 507097 Kittitas Valley Home Health & Hospice 1506 E Radio Rd Ellensburg WA 10 (Seattle) 06/06/2018 SKPD11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0512 Standard: Initial assessment visit. Standard
G0682 Infection Prevention Standard
G0702 Services by skilled professionals Standard
G0488 Immediate reporting of abuse by all staff Element
▼ 507099 Lhcg Lxiii, Llc 6100 219th St Sw, Ste 270 Mountlake Terrace WA 10 (Seattle) 06/11/2025 65C51-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
G0682 Infection Prevention Standard
G0514 RN performs assessment Element
G0520 5 calendar days after start of care Element
G0966 Assure patient needs are continually assessed Element
▼ 507099 Lhcg Lxiii, Llc 6100 219th St Sw, Ste 270 Mountlake Terrace WA 10 (Seattle) 10/07/2022 5D847-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0860 Licensing Standard
▼ 507100 Cascades Healthcare Llc 160 Cascade Pl Ste 103 Burlington WA 10 (Seattle) 04/10/2024 626C8-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0510 Comprehensive Assessment of Patients Condition
G0374 Accuracy of encoded OASIS data Standard
G0572 Plan of care Standard
G0514 RN performs assessment Element
G0520 5 calendar days after start of care Element
▼ 507100 Cascades Healthcare Llc 160 Cascade Pl Ste 103 Burlington WA 10 (Seattle) 01/30/2018 8Z3211 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0118 COMPLIANCE WITH FED, STATE, LOCAL LAWS Standard
G0143 COORDINATION OF PATIENT SERVICES Standard
G0144 COORDINATION OF PATIENT SERVICES Standard
G0158 ACCEPTANCE OF PATIENTS, POC, MED SUPER Standard
G0187 THERAPY SERVICES Standard
G0332 INITIAL ASSESSMENT VISIT Standard
▼ 507101 Symbol Healthcare, Inc 4002 Tacoma Mall Blvd Ste 204 Tacoma WA 10 (Seattle) 02/27/2020 7G7011 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0860 Licensing Standard