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
▼ 527137 St. Croix Valley Shared Services Inc. 990 Main St, Suite 1 Baldwin WI 5 (Chicago) 12/14/2022 5E7C2-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0710 Provide services in the plan of care Element
▼ 527137 St. Croix Valley Shared Services Inc. 990 Main St, Suite 1 Baldwin WI 5 (Chicago) 09/16/2020 P97911 Focused Infection Control, Other-Fed, 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
▼ 527151 Commonheart, Inc. N16w23217 Stone Ridge Dr. Waukesha WI 5 (Chicago) 10/01/2025 1D7F7D-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0536 A review of all current medications Element
▼ 527154 Holy Family Memorial Inc. 1520 S. 41st St. Manitowoc WI 5 (Chicago) 02/18/2025 65438-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0372 Encoding and transmitting OASIS Standard
G0428 Property and person treated with respect Element
G0434 Participate in care Element
G0436 Receive all services in plan of care Element
G0478 Investigate complaints made by patient Element
G0486 Protect patient during investigation Element
G0488 Immediate reporting of abuse by all staff Element
G1012 Required items in clinical record Element
▼ 527154 Holy Family Memorial Inc. 1520 S. 41st St. Manitowoc WI 5 (Chicago) 04/04/2019 9OO511 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0030 Names and Contact Information Standard
G1030 Retrieval of records Standard
G0440 Payment from federally funded programs Element
▼ 527166 Preferred Home Health Care Inc. 1476 Kenwood Dr Menasha WI 5 (Chicago) 01/25/2019 S7R311 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
G0680 Infection prevention and control 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
E0036 EP Training and Testing Standard
E0039 EP Testing Requirements Standard
G0452 Transfer and discharge Standard
G0642 Program scope Standard
G0644 Program data Standard
G0646 Program activities Standard
G0654 Track adverse patient events Standard
G0658 Performance improvement projects Standard
G0660 Executive responsibilities for QAPI Standard
G0682 Infection Prevention Standard
G0684 Infection control Standard
G0440 Payment from federally funded programs Element
G0648 High risk, high volume, or problem-prone area Element
G0650 Incidence, prevalence, severity of problems Element
G0652 Activities lead to an immediate correction Element
G0656 Improvements are sustained Element
▼ 527177 Laabs Home Health Care Inc 619 N 35th St Milwaukee WI 5 (Chicago) 12/10/2024 64D05-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
G0616 Patient medication schedule/instructions Element
▼ 527177 Laabs Home Health Care Inc 619 N 35th St Milwaukee WI 5 (Chicago) 01/12/2022 38212-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
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
G0660 Executive responsibilities for QAPI Standard
G0574 Plan of care must include the following Element
▼ 527177 Laabs Home Health Care Inc 619 N 35th St Milwaukee WI 5 (Chicago) 07/27/2020 6VX111 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0544 Update of the comprehensive assessment Standard
G1024 Authentication Standard
G1014 Interventions and patient response Element
▼ 527178 Prohealth Home Care, Inc. N17w24100 Riverwood Dr., Suite 200 Waukesha WI 5 (Chicago) 04/01/2025 65A30-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0406 Condition of Participation: Patient rights. Condition
G0458 Outcomes/goals have been achieved Element