S&C QCOR HHA 2567s
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HHAs 2567s
Selection Criteria ▸

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
▼ 677928 Dj Home Care, Inc. 9300 John Hickman Pkwy Bldg 2 Ste 20 Frisco TX 6 (Dallas) 04/19/2024 62CC6-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G1012 Required items in clinical record Element
▼ 677929 Nurse Care Home Health Agency Inc 10925 Estate Ln Ste 309 Dallas TX 6 (Dallas) 06/13/2023 5FEAE-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
G0526 Content of the comprehensive assessment Standard
G0660 Executive responsibilities for QAPI Standard
G0684 Infection control Standard
G0446 Contact info Federal/State-funded entities Element
G0484 Document complaint and resolution Element
G0574 Plan of care must include the following Element
G0948 Responsible for all day-to-day operations Element
▼ 677934 Arisco Home Healthcare Services Inc 118 North Main Street Suite C Victoria TX 6 (Dallas) 04/06/2018 UOXA11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0710 Provide services in the plan of care Element
G1012 Required items in clinical record Element
▼ 677937 Eminent Home Healthcare Llc 10864 Audelia Rd #100 Dallas TX 6 (Dallas) 02/06/2018 LGW611 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0574 Plan of care must include the following Element
▼ 677943 Camden Bay Ltd 5211 Sw 9th Avenue Amarillo TX 6 (Dallas) 03/03/2025 654CE-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0800 Services provided by HH aide Element
▼ 677945 Divineheart Healthcare Inc 12959 Jupiter Road Ste 115 Dallas TX 6 (Dallas) 03/14/2018 WH1O11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0660 Executive responsibilities for QAPI Standard
G0962 Coordinate patient care Element
▼ 677946 Dj Montgomery Enterprise Llc 860 Hebron Parkway Suite 703 Lewisville TX 6 (Dallas) 05/21/2021 C8Q111 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0442 Written notice for non-covered care Element
G0574 Plan of care must include the following Element
▼ 677946 Dj Montgomery Enterprise Llc 860 Hebron Parkway Suite 703 Lewisville TX 6 (Dallas) 06/01/2018 6HLN11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0768 Competency evaluation Standard
G0442 Written notice for non-covered care Element
G1014 Interventions and patient response Element
▼ 677946 Dj Montgomery Enterprise Llc 860 Hebron Parkway Suite 703 Lewisville TX 6 (Dallas) 06/01/2018 I9QX12 Recertification
Deficiency Tag Deficiency Description Tag Type
G0101 PATIENT RIGHTS Standard
▼ 677948 Ebenezer Home Health Care Llc 1515 E Kearney St Suite 100 Mesquite TX 6 (Dallas) 04/25/2018 GUQ311 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0614 Visit schedule Element