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
▼ 683124 Etairos Health Inc 1650 Sand Lake Rd Orlando FL 4 (Atlanta) 07/22/2020 62PQ11 Complaint, Focused Infection Control, Other-Fed
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0478 Investigate complaints made by patient Element
G0814 Non-skilled direct observation every 60 days Element
▼ 683125 Golden Age Home Health Agency Corp 7370 College Pkwy Ste 305 Fort Myers FL 4 (Atlanta) 08/12/2021 11444-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0442 Written notice for non-covered care Element
▼ 683126 Corpas Home Health Care Llc 422 S Kings Ave Brandon FL 4 (Atlanta) 04/21/2026 22C366-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0682 Infection Prevention Standard
G0710 Provide services in the plan of care Element
▼ 683140 Elder Alternatives Inc 200 Knuth Rd Ste 200g Boynton Beach FL 4 (Atlanta) 03/04/2021 0OPN11 Complaint, Focused Infection Control, Other-Fed
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0488 Immediate reporting of abuse by all staff Element
▼ 683161 Mega Senior Services Inc 1840 Forest Hill Blvd Ste 203 West Palm Beach FL 4 (Atlanta) 05/01/2024 625AD-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0710 Provide services in the plan of care Element
▼ 683171 Royalty Care Home Health Services Llc 12734 Kenwood Ln, 5 And 6 Fort Myers FL 4 (Atlanta) 06/06/2018 PS4F11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0704 Responsibilities of skilled professionals Standard
G0720 Participate in the HHA's QAPI program; Element
▼ 683172 Imperium Healthcare Inc. 6611 Us Hwy 19 Ste 207 New Port Richey FL 4 (Atlanta) 02/19/2018 EGEP11 Complaint
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
G0572 Plan of care Standard
G0642 Program scope Standard
G0982 Skilled services furnished Standard
G0574 Plan of care must include the following Element
G0576 All orders recorded in plan of care Element
G0706 Interdisciplinary assessment of the patient Element
G0716 Preparing clinical notes Element
G0968 Assure implementation of plan of care Element
G0978 Must have a written agreement Element
▼ 683175 Admiralty Home Health Care 12161 Ken Adams Way Ste 170 Palm Beach Gardens FL 4 (Atlanta) 08/02/2018 CQRY11 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
G0372 Encoding and transmitting OASIS Standard
G0574 Plan of care must include the following Element
G0580 Only as ordered by a physician Element
G0616 Patient medication schedule/instructions Element
▼ 683176 Crown Home Health Care, Inc 3900 Lake Center Dr Ste A4 Mount Dora FL 4 (Atlanta) 05/11/2018 GN3L12 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
E0004 Develop EP Plan, Review and Update Annually Standard
▼ 683176 Crown Home Health Care, Inc 3900 Lake Center Dr Ste A4 Mount Dora FL 4 (Atlanta) 03/07/2018 OE9O11 Recertification, Sample Validation
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
G0660 Executive responsibilities for QAPI Standard
G0412 Written notice of patient's rights Element
G0954 Ensures qualified pre-designated person Element