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
▼ 557490 Unique Home Health Services Inc 596 N Lake Ave Ste 100 Pasadena CA 9 (San Francisco) 12/18/2023 617E5-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G1052 Administrator Standard
G0532 Continuing need for home care Element
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
G0588 Reviewed, revised by physician every 60 days Element
▼ 557490 Unique Home Health Services Inc 596 N Lake Ave Ste 100 Pasadena CA 9 (San Francisco) 12/18/2023 61C97-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0532 Continuing need for home care Element
G0574 Plan of care must include the following Element
▼ 557490 Unique Home Health Services Inc 596 N Lake Ave Ste 100 Pasadena CA 9 (San Francisco) 12/06/2019 8D9G11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0536 A review of all current medications Element
G0618 Treatments and therapy services Element
G0710 Provide services in the plan of care Element
G0714 Patient and caregiver education Element
▼ 557494 Excel Home Health 5575 Lake Parkway, Suite 220 La Mesa CA 9 (San Francisco) 07/11/2019 LQWM11 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
G1028 Protection of records Standard
G0514 RN performs assessment Element
G0536 A review of all current medications Element
▼ 557514 Staff Assistance, Inc. 10550 Sepulveda Blvd, Ste. 118 Mission Hills CA 9 (San Francisco) 08/19/2022 4F3A8-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
G0606 Integrate all services Element
▼ 557514 Staff Assistance, Inc. 10550 Sepulveda Blvd, Ste. 118 Mission Hills CA 9 (San Francisco) 07/11/2019 D4QV11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0578 Conformance with physician orders Standard
G0478 Investigate complaints made by patient Element
G0536 A review of all current medications Element
G0580 Only as ordered by a physician Element
G0608 Coordinate care delivery Element
G0714 Patient and caregiver education Element
G1014 Interventions and patient response Element
▼ 557517 Oroville Hospital 1960 Feather River Boulevard Oroville CA 9 (San Francisco) 03/23/2022 38642-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
G0526 Content of the comprehensive assessment Standard
G0578 Conformance with physician orders Standard
G0682 Infection Prevention Standard
G0702 Services by skilled professionals Standard
G0460 Patient refuses services Element
G0514 RN performs assessment Element
G0548 Within 48 hours of the patient's return Element
G0590 Promptly alert relevant physician of changes Element
G0812 Direct observation every 12 months Element
▼ 557517 Oroville Hospital 1960 Feather River Boulevard Oroville CA 9 (San Francisco) 04/25/2019 6RH811 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0578 Conformance with physician orders Standard
G0514 RN performs assessment Element
G0574 Plan of care must include the following Element
G0710 Provide services in the plan of care Element
G0716 Preparing clinical notes Element
G0968 Assure implementation of plan of care Element
G1012 Required items in clinical record Element
▼ 557550 Practicare Home Health Agency 223 N First Ave, Suite 103 Arcadia CA 9 (San Francisco) 12/16/2022 5E854-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0610 Patients receive education and training Element
G0616 Patient medication schedule/instructions Element
G0714 Patient and caregiver education Element
▼ 557550 Practicare Home Health Agency 223 N First Ave, Suite 103 Arcadia CA 9 (San Francisco) 08/09/2019 QN7U11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0536 A review of all current medications Element