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
▼ 553198 Unity Home Health Providers, Inc 1415 W Magnolia Blvd Suite 102 Burbank CA 9 (San Francisco) 12/19/2025 1D87F0-H2 Complaint
Deficiency Tag Deficiency Description Tag Type
G0572 Plan of care Standard
▼ 553198 Unity Home Health Providers, Inc 1415 W Magnolia Blvd Suite 102 Burbank CA 9 (San Francisco) 10/06/2025 1D87F0-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0370 Reporting OASIS information Condition
G0570 Care planning, coordination, quality of care Condition
G0640 Quality assessment/performance improvement Condition
G0700 Skilled professional services Condition
G1008 Clinical records Condition
G0372 Encoding and transmitting OASIS Standard
G0642 Program scope Standard
G0658 Performance improvement projects Standard
G0660 Executive responsibilities for QAPI Standard
G1024 Authentication Standard
G0576 All orders recorded in plan of care Element
G0588 Reviewed, revised by physician every 60 days Element
G0590 Promptly alert relevant physician of changes Element
G0592 Revised plan of care Element
G0616 Patient medication schedule/instructions Element
G0656 Improvements are sustained Element
G0716 Preparing clinical notes Element
G0728 Rehab services supervised by PT, OT Element
G1012 Required items in clinical record Element
▼ 557002 Maxim Healthcare Services, Inc. 3111 Camino Del Rio North, Suite 1200 San Diego CA 9 (San Francisco) 01/26/2023 5EC25-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
▼ 557002 Maxim Healthcare Services, Inc. 3111 Camino Del Rio North, Suite 1200 San Diego CA 9 (San Francisco) 10/18/2022 YXYN11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0482 Mistreatment, neglect or abuse Element
G0488 Immediate reporting of abuse by all staff Element
▼ 557005 Extended Health Care, Inc. 1718 E Artesia Blvd Long Beach CA 9 (San Francisco) 12/09/2022 38A04-H4 Recertification
Deficiency Tag Deficiency Description Tag Type
G0572 Plan of care Standard
G0684 Infection control Standard
G0724 Supervise skilled professional assistants Standard
G0942 Governing body Standard
G0970 Parent-branch relationship Standard
G0436 Receive all services in plan of care Element
G0574 Plan of care must include the following Element
G0590 Promptly alert relevant physician of changes Element
G0610 Patients receive education and training Element
G0974 Direct support and administrative control Element
▼ 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