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
▼ 537063 St John's Home Care 555 East Broadway, Ste 115 Jackson WY 8 (Denver) 10/18/2018 E0C211 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0798 Home health aide assignments and duties Standard
G0536 A review of all current medications Element
G0946 Administrator appointed by governing body Element
G0954 Ensures qualified pre-designated person Element
▼ 537069 Wyoming Home Health Inc Dba/Home And Care Gillette 1103 E Boxelder Rd, Ste J-B Gillette WY 8 (Denver) 05/13/2021 TKVI11 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
G0798 Home health aide assignments and duties Standard
G0514 RN performs assessment Element
G0984 In accordance with current clinical practice Element
▼ 537069 Wyoming Home Health Inc Dba/Home And Care Gillette 1103 E Boxelder Rd, Ste J-B Gillette WY 8 (Denver) 05/24/2018 1BW611 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0798 Home health aide assignments and duties Standard
G0574 Plan of care must include the following Element
G0808 Onsite supervisory visit every 14 days Element
G0984 In accordance with current clinical practice Element
▼ 537073 Star Valley Healthcare Inc Dba/Symbii Home Health 770 S Washington St, Ste B Afton WY 8 (Denver) 01/16/2025 651F4-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
G0984 In accordance with current clinical practice Element
▼ 537073 Star Valley Healthcare Inc Dba/Symbii Home Health 770 S Washington St, Ste B Afton WY 8 (Denver) 01/06/2022 381B0-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0984 In accordance with current clinical practice Element
▼ 537073 Star Valley Healthcare Inc Dba/Symbii Home Health 770 S Washington St, Ste B Afton WY 8 (Denver) 01/10/2019 I5N911 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0798 Home health aide assignments and duties Standard
G0436 Receive all services in plan of care Element
G0574 Plan of care must include the following Element
G0984 In accordance with current clinical practice Element
▼ 537073 Star Valley Healthcare Inc Dba/Symbii Home Health 770 S Washington St, Ste B Afton WY 8 (Denver) 01/10/2019 IXQU11 Other-Fed
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
E0039 EP Testing Requirements Standard
▼ 537074 Rock Springs Young At Heart 2400 Reagan Ave Rock Springs WY 8 (Denver) 08/15/2024 63EB0-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0684 Infection control Standard
G0436 Receive all services in plan of care Element
G0574 Plan of care must include the following Element
▼ 537074 Rock Springs Young At Heart 2400 Reagan Ave Rock Springs WY 8 (Denver) 08/05/2021 TRRI11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0682 Infection Prevention Standard
G0684 Infection control Standard
G0436 Receive all services in plan of care Element
G0808 Onsite supervisory visit every 14 days Element
▼ 537074 Rock Springs Young At Heart 2400 Reagan Ave Rock Springs WY 8 (Denver) 01/11/2018 7PI511 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0101 PATIENT RIGHTS Standard
G0111 CONFIDENTIALITY OF MEDICAL RECORDS Standard
G0121 COMPLIANCE W/ ACCEPTED PROFESSIONAL STD Standard
G0137 ADMINISTRATOR Standard
G0142 PERSONNEL HOURLY/PER VISIT CONTRACT Standard
G0159 PLAN OF CARE Standard
G0212 COMPETENCY EVALUATION & IN-SERVICE TRAI Standard