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
▼ 559317 Nelnar Home Health Care, Inc 2607 Colorado Blvd Unit 107 Eagle Rock CA 9 (San Francisco) 04/07/2024 61EAC-H2 Recertification
Deficiency Tag Deficiency Description Tag Type
G0612 Written instructions to patient include: Standard
G0536 A review of all current medications Element
▼ 559317 Nelnar Home Health Care, Inc 2607 Colorado Blvd Unit 107 Eagle Rock CA 9 (San Francisco) 01/11/2024 61EAC-H1 Recertification
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
G0520 5 calendar days after start of care Element
G0522 Eligibility for Medicare home health benefit Element
G0606 Integrate all services Element
G0614 Visit schedule Element
G0616 Patient medication schedule/instructions Element
▼ 559338 Music Home Health 13746 Victory Blvd Suite 302 Van Nuys CA 9 (San Francisco) 09/06/2024 61E4B-H2 Complaint
Deficiency Tag Deficiency Description Tag Type
G1018 Contact information for the patient Element
▼ 559338 Music Home Health 13746 Victory Blvd Suite 302 Van Nuys CA 9 (San Francisco) 01/07/2024 61E4B-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0406 Patient rights Condition
G0510 Comprehensive Assessment of Patients Condition
G0570 Care planning, coordination, quality of care Condition
G0452 Transfer and discharge Standard
G0544 Update of the comprehensive assessment Standard
G0572 Plan of care Standard
G0434 Participate in care Element
G0536 A review of all current medications Element
G0580 Only as ordered by a physician Element
G0590 Promptly alert relevant physician of changes Element
▼ 559342 Living Hope Home Health Care 4405 W Riverside Dr. Suite 214 Burbank CA 9 (San Francisco) 02/14/2024 62387-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0570 Care planning, coordination, quality of care Condition
G0940 Organization and administration of services Condition
G1008 Clinical records Condition
G0586 Review and revision of the plan of care Standard
G1024 Authentication Standard
G1052 Administrator Standard
G0536 A review of all current medications Element
G0590 Promptly alert relevant physician of changes Element
G0726 Nursing services supervised by RN Element
G0950 Ensure clinical manager is available Element
G0968 Assure implementation of plan of care Element
G1012 Required items in clinical record Element
▼ 559420 First Priority Home Health Care, Inc 120 N Victory Blvd Suite 306 Burbank CA 9 (San Francisco) 09/06/2024 6138F-H2 Complaint
Deficiency Tag Deficiency Description Tag Type
G0406 Patient rights Condition
G0412 Written notice of patient's rights Element
▼ 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