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
▼ 557005 Extended Health Care, Inc. 1718 E Artesia Blvd Long Beach CA 9 (San Francisco) 08/29/2022 38A04-H3 Recertification
Deficiency Tag Deficiency Description Tag Type
G0374 Accuracy of encoded OASIS data Standard
G0704 Responsibilities of skilled professionals Standard
▼ 557005 Extended Health Care, Inc. 1718 E Artesia Blvd Long Beach CA 9 (San Francisco) 06/09/2022 38A04-H2 Recertification
Deficiency Tag Deficiency Description Tag Type
G0480 Treatment or care Element
G0948 Responsible for all day-to-day operations Element
▼ 557005 Extended Health Care, Inc. 1718 E Artesia Blvd Long Beach CA 9 (San Francisco) 04/28/2022 38A04-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0700 Skilled professional services Condition
E0013 Development of EP Policies and Procedures Standard
G0682 Infection Prevention Standard
G0702 Services by skilled professionals Standard
G0752 Home health aide qualifications Standard
G0536 A review of all current medications Element
G0580 Only as ordered by a physician Element
G0710 Provide services in the plan of care Element
G0952 Ensure that HHA employs qualified personnel Element
▼ 557008 Pioneer Home Health Care 363 Academy Ave Bishop CA 9 (San Francisco) 05/15/2025 66174-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
G0684 Infection control Standard
G0436 Receive all services in plan of care Element
G0464 Advise the patient of discharge for cause Element
G0536 A review of all current medications Element
▼ 557008 Pioneer Home Health Care 363 Academy Ave Bishop CA 9 (San Francisco) 04/21/2022 3881E-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
▼ 557008 Pioneer Home Health Care 363 Academy Ave Bishop CA 9 (San Francisco) 03/08/2019 HV5R11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0570 Care planning, coordination, quality of care Condition
E0037 EP Training Program Standard
G0410 Information to patient Element
G0438 Have a confidential clinical record Element
G0580 Only as ordered by a physician Element
G0584 Verbal orders Element
G0590 Promptly alert relevant physician of changes Element
▼ 557012 Kaiser Foundation Hospital Home Health - Martinez 200 Muir Road, Hacienda Building Martinez CA 9 (San Francisco) 03/29/2023 5F68A-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0512 Standard: Initial assessment visit. Standard
G0682 Infection Prevention Standard
G0436 Receive all services in plan of care Element
G0520 5 calendar days after start of care Element
G0706 Interdisciplinary assessment of the patient Element
▼ 557012 Kaiser Foundation Hospital Home Health - Martinez 200 Muir Road, Hacienda Building Martinez CA 9 (San Francisco) 02/26/2018 IFFJ11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0514 RN performs assessment Element
G0590 Promptly alert relevant physician of changes Element
▼ 557014 United Home Care 245 New York Ranch Rd, Ste C Jackson CA 9 (San Francisco) 07/13/2023 6034D-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
G0608 Coordinate care delivery Element
▼ 557020 Interim Healthcare San Diego Home Health 5625 Ruffin Road, Suite 225 San Diego CA 9 (San Francisco) 02/06/2020 8HHG11 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