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
▼ 527234 Interim Healthcare Of Ne Wi Inc. 110 Packerland Dr., Suite D Green Bay WI 5 (Chicago) 11/17/2022 5E177-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
G0434 Participate in care Element
G0956 Available during all operating hours Element
▼ 527237 Kochas Interim Healthcare, Inc. 327 N 17th Ave, Suite 7 Wausau WI 5 (Chicago) 11/08/2023 616F6-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
G0536 A review of all current medications Element
▼ 527237 Kochas Interim Healthcare, Inc. 327 N 17th Ave, Suite 7 Wausau WI 5 (Chicago) 05/16/2023 5FA3A-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0952 Ensure that HHA employs qualified personnel Element
▼ 527240 Professional Home Care Services, Inc. 10827 West Lincoln Ave West Allis WI 5 (Chicago) 04/02/2025 65C3B-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
G0682 Infection Prevention Standard
▼ 527249 Sai Home Health Care Inc 5200 Washington Ave Ste 227 Racine WI 5 (Chicago) 05/10/2018 4NY211 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
G0726 Nursing services supervised by RN Element
G1016 Goals in the patient's plans of care Element
▼ 527257 Affiliated Home Health Care Inc. 6737 W. Washington St., Suite 2211 West Allis WI 5 (Chicago) 11/09/2023 61693-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
G0680 Infection prevention and control Condition
G0940 Organization and administration of services Condition
G0572 Plan of care Standard
G0684 Infection control Standard
G0982 Skilled services furnished Standard
▼ 527257 Affiliated Home Health Care Inc. 6737 W. Washington St., Suite 2211 West Allis WI 5 (Chicago) 11/18/2020 B1YA11 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
G0658 Performance improvement projects Standard
▼ 527263 Divine Savior Healthcare Inc. 2805 Hunters Trail Portage WI 5 (Chicago) 02/01/2019 HTD811 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0432 Make complaints to the HHA Element
G0574 Plan of care must include the following Element
▼ 527266 Catalyst, Inc. 230 S. Hamilton St. Madison WI 5 (Chicago) 04/15/2025 65E3D-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0940 Organization and administration of services Condition
G0948 Responsible for all day-to-day operations Element
G0954 Ensures qualified pre-designated person Element
▼ 527272 Hha Of Wisconsin, Llc 3900 Hall Ave Suite A Marinette WI 5 (Chicago) 12/04/2024 64BE6-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
G0580 Only as ordered by a physician Element
G0602 Communication with all physicians Element