S&C QCOR HHA 2567s
d QCOR: Quality, Certification and Oversight Reports. S&C QCOR  
Home  |  Help  |  Resources  |  FAQs  |  Site Map  
   
HHAs 2567s
Selection Criteria ▸

Time Interval

Please select the calendar year or years for which you would like data.

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
▼ 527083 Horizon Home Care And Hospice Inc. 11002 West Park Place Milwaukee WI 5 (Chicago) 08/09/2018 WLMO11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0590 Promptly alert relevant physician of changes Element
G0596 Revisions communicated to patient and MDs Element
▼ 527085 Calumet County 206 Court St Courthouse Chilton WI 5 (Chicago) 03/19/2024 628D5-H1 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
E0009 Local, State, Tribal Collaboration Process Standard
E0013 Development of EP Policies and Procedures Standard
E0023 Policies/Procedures for Medical Documentation Standard
E0032 Primary/Alternate Means for Communication Standard
E0037 EP Training Program Standard
G0726 Nursing services supervised by RN Element
G0808 Onsite supervisory visit every 14 days Element
▼ 527085 Calumet County 206 Court St Courthouse Chilton WI 5 (Chicago) 03/28/2018 3HVP11 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
G0574 Plan of care must include the following Element
G1016 Goals in the patient's plans of care Element
▼ 527094 Hha Of Wisconsin, Llc 2100 Riverside Dr Suite 103 Green Bay WI 5 (Chicago) 12/12/2023 61A5B-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0578 Conformance with physician orders Standard
G0574 Plan of care must include the following Element
▼ 527094 Hha Of Wisconsin, Llc 2100 Riverside Dr Suite 103 Green Bay WI 5 (Chicago) 12/16/2020 Q6GH11 Complaint, 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
▼ 527098 Centerwell Certified Healthcare Corp 6233 Bankers Road Suite 1 Racine WI 5 (Chicago) 11/26/2019 BIPJ11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0574 Plan of care must include the following Element
▼ 527113 Agnesian Healthcare Inc. 239 Trowbridge Drive Fond Du Lac WI 5 (Chicago) 12/09/2025 1DD5CB-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
G0800 Services provided by HH aide Element
▼ 527113 Agnesian Healthcare Inc. 239 Trowbridge Drive Fond Du Lac WI 5 (Chicago) 09/28/2022 4F7A8-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0608 Coordinate care delivery Element
▼ 527113 Agnesian Healthcare Inc. 239 Trowbridge Drive Fond Du Lac WI 5 (Chicago) 01/15/2020 8SHF11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0706 Interdisciplinary assessment of the patient Element
▼ 527137 St. Croix Valley Shared Services Inc. 990 Main St, Suite 1 Baldwin WI 5 (Chicago) 09/13/2023 60FB6-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
G0418 Patient's or legal representative's signature Element
G0574 Plan of care must include the following Element