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
▼ 537834 Premium Health At Home Rawlins Llc 405 W Cedar St., Suite B Rawlins WY 8 (Denver) 07/23/2024 63B83-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0037 EP Training Program Standard
E0039 EP Testing Requirements Standard
G0642 Program scope Standard
G0590 Promptly alert relevant physician of changes Element
G0710 Provide services in the plan of care Element
▼ 537834 Premium Health At Home Rawlins Llc 405 W Cedar St., Suite B Rawlins WY 8 (Denver) 07/15/2021 FZBC11 Focused Infection Control, Other-Fed, Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0642 Program scope Standard
G0682 Infection Prevention Standard
G0434 Participate in care Element
G0514 RN performs assessment Element
G0984 In accordance with current clinical practice Element
▼ 553106 Hhs Homecare, Inc 10875 La Tuna Canyon Road Sun Valley CA 9 (San Francisco) 11/09/2023 61733-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0798 Home health aide assignments and duties Standard
G1028 Protection of records Standard
G0444 State toll free HH telephone hotline Element
G0536 A review of all current medications Element
G0726 Nursing services supervised by RN Element
G1012 Required items in clinical record Element
▼ 553111 Apollo Home Healthcare 7901 Stoneridge Dr. Pleasanton CA 9 (San Francisco) 10/27/2025 1D9FF9-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0436 Receive all services in plan of care Element
▼ 553127 Bay Nation Home Health Services Inc. 39675 Cedar Blvd, Suite 235 Newark CA 9 (San Francisco) 05/19/2026 22E760-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0406 Condition of Participation: Patient rights. Condition
G0438 Have a confidential clinical record Element
G0548 Within 48 hours of the patient's return Element
G0580 Only as ordered by a physician Element
▼ 553131 Amberkare Home Health, Inc 595 W Lambert Rd, Ste 201 Brea CA 9 (San Francisco) 04/23/2026 22EC72-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0009 Local, State, Tribal Collaboration Process Standard
E0019 Homebound HHA/Hospice Inform EP Officials Standard
E0021 HHA- Procedures for Follow up Staff/Pts. Standard
E0023 Policies/Procedures for Medical Documentation Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0031 Emergency Officials Contact Information Standard
E0033 Methods for Sharing Information Standard
E0034 Information on Occupancy/Needs Standard
G0564 Discharge or Transfer Summary Content Standard
G0572 Plan of care Standard
G0514 RN performs assessment Element
G0520 5 calendar days after start of care Element
G0536 A review of all current medications Element
G0546 Last 5 days of every 60 days unless: Element
G0574 Plan of care must include the following Element
G0580 Only as ordered by a physician Element
G0588 Reviewed, revised by physician every 60 days Element
G0604 Integrate all orders Element
G0614 Visit schedule Element
G0710 Provide services in the plan of care Element
G0714 Patient and caregiver education Element
G0716 Preparing clinical notes Element
G0726 Nursing services supervised by RN Element
G0808 Onsite supervisory visit every 14 days Element
G0948 Responsible for all day-to-day operations Element
G1022 Discharge and transfer summaries Element
▼ 553131 Amberkare Home Health, Inc 595 W Lambert Rd, Ste 201 Brea CA 9 (San Francisco) 04/24/2023 5F8A4-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0006 Plan Based on All Hazards Risk Assessment Standard
E0009 Local, State, Tribal Collaboration Process Standard
E0021 HHA- Procedures for Follow up Staff/Pts. Standard
E0023 Policies/Procedures for Medical Documentation Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0030 Names and Contact Information Standard
E0031 Emergency Officials Contact Information Standard
E0033 Methods for Sharing Information Standard
E0034 Information on Occupancy/Needs Standard
E0037 EP Training Program Standard
G0642 Program scope Standard
G0682 Infection Prevention Standard
G0684 Infection control Standard
G0687 COVID-19 Vaccination of Home Health Agency staff Standard
G0536 A review of all current medications Element
G0608 Coordinate care delivery Element
G0610 Patients receive education and training Element
G0614 Visit schedule Element
G0710 Provide services in the plan of care Element
G0716 Preparing clinical notes Element
G0948 Responsible for all day-to-day operations Element
G1022 Discharge and transfer summaries Element
▼ 553140 Attain Health Home Health, Inc. 1513 Aviation Boulevard Redondo Beach CA 9 (San Francisco) 05/29/2026 233AC0-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0570 Care planning, coordination, quality of care Condition
G0680 Infection prevention and control Condition
G0572 Plan of care Standard
G0612 Written instructions to patient include: Standard
G0682 Infection Prevention Standard
G0574 Plan of care must include the following Element
G0602 Communication with all physicians Element
▼ 553142 Vivian Home Health, Inc 936 West Ave J-4, Unit 201-A Lancaster CA 9 (San Francisco) 02/25/2020 E88211 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0406 Patient rights Condition
G0510 Comprehensive Assessment of Patients Condition
G0640 Quality assessment/performance improvement Condition
G1008 Clinical records Condition
G1050 Personnel qualifications Condition
G0452 Transfer and discharge Standard
G0642 Program scope Standard
G0644 Program data Standard
G0646 Program activities Standard
G0942 Governing body Standard
G0944 Administrator must: Standard
G1028 Protection of records Standard
G1052 Administrator Standard
G0438 Have a confidential clinical record Element
G0462 Before discharge for cause HHA must: Element
G0464 Advise the patient of discharge for cause Element
G0466 Make efforts to resolve the problem(s) Element
G0468 Provide contact info other services Element
G0470 Document efforts to resolve problems Element
G0542 Incorporate OASIS items Element
G0598 Discharge plans communication 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
G0716 Preparing clinical notes Element
G0720 Participate in the HHA's QAPI program; Element
G0948 Responsible for all day-to-day operations Element
G0956 Available during all operating hours Element
G1022 Discharge and transfer summaries Element
▼ 553189 Optimum Ma Home Health Care, Inc 5658 Sepulveda Blvd, Suite 208 Van Nuys CA 9 (San Francisco) 05/07/2021 ONJP11 Complaint, Sample Validation
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0570 Care planning, coordination, quality of care Condition
G0372 Encoding and transmitting OASIS Standard
G0572 Plan of care Standard
G0536 A review of all current medications Element
G0584 Verbal orders Element
G0716 Preparing clinical notes Element