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
▼ 559420 First Priority Home Health Care, Inc 120 N Victory Blvd Suite 306 Burbank CA 9 (San Francisco) 10/13/2023 6138F-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0570 Care planning, coordination, quality of care Condition
G1008 Clinical records Condition
G0572 Plan of care Standard
G1028 Protection of records Standard
G0574 Plan of care must include the following Element
G0602 Communication with all physicians Element
G0710 Provide services in the plan of care Element
G1012 Required items in clinical record Element
▼ 559426 Southern Star Home Healthcare, Inc. 1011 W La Palma Ave Suite 102 Anaheim CA 9 (San Francisco) 12/06/2023 619D9-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0019 Homebound HHA/Hospice Inform EP Officials Standard
E0030 Names and Contact Information Standard
E0037 EP Training Program Standard
G0572 Plan of care Standard
G1024 Authentication Standard
G0444 State toll free HH telephone hotline Element
G0514 RN performs assessment Element
G0520 5 calendar days after start of care Element
G0536 A review of all current medications 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
▼ 559454 Brilliant Health Home Care Inc 730 S Central Ave Unit 205 Glendale CA 9 (San Francisco) 02/01/2024 62183-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
G0522 Eligibility for Medicare home health benefit Element
▼ 559461 Trusted Quality Home Health, Inc 120 N Victory Blvd Suite 303 Burbank CA 9 (San Francisco) 05/26/2024 632AF-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
G0848 Compliance with Federal, State, Local Law Condition
G1008 Clinical records Condition
G0572 Plan of care Standard
G0850 Disclosure of ownership and management info. Standard
G0860 Licensing Standard
G1024 Authentication Standard
G0528 Health, psychosocial, functional, cognition Element
G0532 Continuing need for home care Element
G0574 Plan of care must include the following Element
G0580 Only as ordered by a physician Element
G0590 Promptly alert relevant physician of changes Element
▼ 559488 G & H Home Health Care, Inc 14652 Ventura Blvd Suite 201 Sherman Oaks CA 9 (San Francisco) 12/14/2023 61B85-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0580 Only as ordered by a physician Element
G1012 Required items in clinical record Element
▼ 559492 Ensure Home Health Care, Inc 20944 Sherman Way Suite 106 Canoga Park CA 9 (San Francisco) 02/25/2024 62223-H1 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
E0004 Develop EP Plan, Review and Update Annually Standard
E0037 EP Training Program Standard
G0572 Plan of care Standard
G0644 Program data Standard
G0942 Governing body Standard
G0576 All orders recorded in plan of care Element
G0580 Only as ordered by a physician Element
G0778 Documentation of inservice training Element
▼ 559495 La Global Home Health Care, Inc 7100 Hayvenhurst Ave Suite 113 Van Nuys CA 9 (San Francisco) 08/17/2024 63EBC-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0510 Comprehensive Assessment of Patients Condition
G1008 Clinical records Condition
G0544 Update of the comprehensive assessment Standard
G0532 Continuing need for home care Element
G0536 A review of all current medications Element
G1012 Required items in clinical record Element
▼ 559500 Sunrise Home Health Care 1612 W Olive Ave Suite 302 Burbank CA 9 (San Francisco) 11/11/2023 617D4-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
G0702 Services by skilled professionals Standard
G0942 Governing body Standard
G0412 Written notice of patient's rights Element
G0444 State toll free HH telephone hotline Element
G0514 RN performs assessment Element
G0536 A review of all current medications Element
▼ 559540 Rosewood Home & Palliative Care, Inc 1241 S Glendale Ave, Suite 301 Glendale CA 9 (San Francisco) 02/08/2024 61286-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0682 Infection Prevention Standard
G0514 RN performs assessment Element
G0536 A review of all current medications Element
G0580 Only as ordered by a physician Element
G0602 Communication with all physicians Element
G1012 Required items in clinical record Element
▼ 559551 West Coast Home Health 29222 Rancho Viejo Road, Suite 201 San Juan Capistrano CA 9 (San Francisco) 12/15/2023 61B72-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0030 Names and Contact Information Standard
G0572 Plan of care Standard
G0644 Program data 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
G0608 Coordinate care delivery 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