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
▼ 059387 Bridge Home Health 5090 Shoreham Place, Suite 109 San Diego CA 9 (San Francisco) 10/16/2020 XYY711 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0576 All orders recorded in plan of care Element
▼ 059389 Excellence Home Health Provider, Inc 4050 Katella Ave Ste # 204 Los Alamitos CA 9 (San Francisco) 10/29/2024 6478D-H1 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
E0034 Information on Occupancy/Needs Standard
G0372 Encoding and transmitting OASIS Standard
G0642 Program scope Standard
G0644 Program data Standard
G0646 Program activities Standard
G0658 Performance improvement projects Standard
G0682 Infection Prevention Standard
G0684 Infection control Standard
G0798 Home health aide assignments and duties Standard
G1024 Authentication Standard
G0478 Investigate complaints made by patient Element
G0514 RN performs assessment Element
G0536 A review of all current medications Element
G0546 Last 5 days of every 60 days unless: Element
G0548 Within 48 hours of the patient's return Element
G0550 At discharge Element
G0574 Plan of care must include the following Element
G0580 Only as ordered by a physician Element
G0602 Communication with all physicians Element
G0614 Visit schedule Element
G0710 Provide services in the plan of care Element
G0716 Preparing clinical notes Element
G0726 Nursing services supervised by RN Element
G0952 Ensure that HHA employs qualified personnel Element
G0978 Must have a written agreement Element
G0984 In accordance with current clinical practice Element
G1022 Discharge and transfer summaries Element
▼ 059389 Excellence Home Health Provider, Inc 4050 Katella Ave Ste # 204 Los Alamitos CA 9 (San Francisco) 12/15/2021 38055-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
E0006 Plan Based on All Hazards Risk Assessment Standard
E0007 EP Program Patient Population 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
E0029 Development of Communication Plan 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
G0586 Review and revision of the plan of care Standard
G0682 Infection Prevention Standard
G0684 Infection control Standard
G0860 Licensing Standard
G0862 Laboratory services/CLIA waivers Standard
G1024 Authentication Standard
G0520 5 calendar days after start of care Element
G0536 A review of all current medications Element
G0548 Within 48 hours of the patient's return Element
G0550 At discharge Element
G0602 Communication with all physicians Element
G0606 Integrate all services Element
G0614 Visit schedule Element
G0622 Name/contact information of clinical manager Element
G0710 Provide services in the plan of care Element
G0716 Preparing clinical notes Element
G0808 Onsite supervisory visit every 14 days Element
G0948 Responsible for all day-to-day operations Element
G1022 Discharge and transfer summaries Element
▼ 059392 Prohealth Home Care, Inc. 2125 Oak Grove Road, Suite 124 A & B Walnut Creek CA 9 (San Francisco) 08/27/2024 641CC-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0436 Receive all services in plan of care Element
▼ 059392 Prohealth Home Care, Inc. 2125 Oak Grove Road, Suite 124 A & B Walnut Creek CA 9 (San Francisco) 06/08/2018 QYK311 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0600 Coordination of Care Standard
G1010 Contents of clinical record Standard
G0536 A review of all current medications Element
G0590 Promptly alert relevant physician of changes Element
▼ 059398 Vital Care Health Systems 444 Camino Del Rio South, Suite 219 San Diego CA 9 (San Francisco) 09/12/2023 5FF6A-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0436 Receive all services in plan of care Element
▼ 059398 Vital Care Health Systems 444 Camino Del Rio South, Suite 219 San Diego CA 9 (San Francisco) 03/15/2021 UGO411 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0580 Only as ordered by a physician Element
▼ 059409 Home Health Plus Services, Inc 900 S First Avenue Suite H Arcadia CA 9 (San Francisco) 03/03/2023 5F287-H1 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
G0536 A review of all current medications Element
▼ 059409 Home Health Plus Services, Inc 900 S First Avenue Suite H Arcadia CA 9 (San Francisco) 08/27/2019 UXSJ11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0522 Eligibility for Medicare home health benefit Element
▼ 059418 Healthwise Home Health Care Inc 1615 Sweetwater Road, Suite 1 National City CA 9 (San Francisco) 08/21/2019 S6NS11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0484 Document complaint and resolution Element
G0574 Plan of care must include the following Element