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
▼ 559187 Avante Home Health Care, Inc 19231 Victory Blvd, Suite 202 Reseda CA 9 (San Francisco) 01/28/2024 62151-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0510 Comprehensive Assessment of Patients Condition
G0640 Quality assessment/performance improvement Condition
G0940 Organization and administration of services Condition
G1008 Clinical records Condition
G0518 Completion of the comprehensive assessment Standard
G0642 Program scope Standard
G0942 Governing body Standard
G0522 Eligibility for Medicare home health benefit Element
G0608 Coordinate care delivery Element
G0648 High risk, high volume, or problem-prone area Element
G0968 Assure implementation of plan of care Element
G1012 Required items in clinical record Element
▼ 559196 Blessed Home Health Care Inc 4900 California Ave., Twr-B 2nd Floor #56 Bakersfield CA 9 (San Francisco) 01/20/2021 25U811 Complaint, Sample Validation
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0684 Infection control Standard
G1010 Contents of clinical record Standard
G0714 Patient and caregiver education Element
▼ 559222 Omega Home Health Agency, Inc 273 W Alameda Ave Burbank CA 9 (San Francisco) 05/07/2023 5FBA5-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
G0572 Plan of care Standard
G0412 Written notice of patient's rights Element
G0532 Continuing need for home care Element
G0536 A review of all current medications Element
G0714 Patient and caregiver education Element
▼ 559224 Gold Star Home Health, Inc 421 Arden Ave. Unit B Glendale CA 9 (San Francisco) 01/21/2021 700311 Complaint, Sample Validation
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0684 Infection control Standard
G0774 12 hours inservice every 12 months Standard
G0536 A review of all current medications Element
G0590 Promptly alert relevant physician of changes Element
G0610 Patients receive education and training Element
G0710 Provide services in the plan of care Element
▼ 559225 Luxury Home Health, Inc 10012 Commerce Ave, Suite C Tujunga CA 9 (San Francisco) 05/05/2023 5FB27-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
G0572 Plan of care Standard
G0682 Infection Prevention Standard
G0684 Infection control Standard
G1052 Administrator Standard
G0412 Written notice of patient's rights Element
G0602 Communication with all physicians Element
G0606 Integrate all services Element
G0610 Patients receive education and training Element
G0616 Patient medication schedule/instructions Element
G1012 Required items in clinical record Element
▼ 559231 Preferred Home Health Services 9608 Van Nuys Blvd. Suite 206 Panorama CA 9 (San Francisco) 06/23/2023 60272-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0039 EP Testing Requirements Standard
G0572 Plan of care Standard
G0642 Program scope Standard
G0412 Written notice of patient's rights Element
G0444 State toll free HH telephone hotline Element
G0536 A review of all current medications Element
G0590 Promptly alert relevant physician of changes Element
G0610 Patients receive education and training Element
G0714 Patient and caregiver education Element
G0968 Assure implementation of plan of care Element
▼ 559249 Delano Home Health Care, Inc. 20501 Ventura Blvd. Suite 280 Woodland Hills CA 9 (San Francisco) 01/23/2025 65271-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0510 Comprehensive Assessment of Patients Condition
G0750 Home health aide services Condition
G0940 Organization and administration of services Condition
G0532 Continuing need for home care Element
G0536 A review of all current medications Element
G0754 A qualified HH aide successfully completed: Element
G0808 Onsite supervisory visit every 14 days Element
G0952 Ensure that HHA employs qualified personnel Element
G1012 Required items in clinical record Element
▼ 559252 Mg Home Health Care, Inc 13758 Victory Blvd, Suite 203 Van Nuys CA 9 (San Francisco) 08/23/2024 63F31-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0406 Condition of Participation: Patient rights. Condition
G0940 Organization and administration of services Condition
G1008 Clinical records Condition
G0562 Discharge Planning Standard
G0860 Licensing Standard
G0942 Governing body Standard
G1028 Protection of records Standard
G0434 Participate in care Element
▼ 559265 Thrive Health Inc. 8407 Lincoln Blvd Los Angeles CA 9 (San Francisco) 06/04/2023 5FF50-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0036 EP Training and Testing Standard
G0572 Plan of care Standard
G0660 Executive responsibilities for QAPI Standard
G0682 Infection Prevention Standard
G0536 A review of all current medications Element
G0580 Only as ordered by a physician Element
G0718 Communication with physicians Element
G0720 Participate in the HHA's QAPI program; Element
▼ 559265 Thrive Health Inc. 8407 Lincoln Blvd Los Angeles CA 9 (San Francisco) 04/13/2023 5F7A3-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0510 Comprehensive Assessment of Patients Condition
G0570 Care planning, coordination, quality of care Condition
G0526 Content of the comprehensive assessment Standard
G0572 Plan of care Standard
G0682 Infection Prevention Standard
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0576 All orders recorded in plan of care Element