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
▼ 05K025 Allied Professional Nursing Care Inc 2345 W Foothill Blvd #14 Upland CA 9 (San Francisco) 08/30/2018 2HQ311 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0578 Conformance with physician orders Standard
G0546 Last 5 days of every 60 days unless: Element
▼ 05K041 Millennium Pro, Inc. 3435 Wilshire Blvd. Suite 2890 Los Angeles CA 9 (San Francisco) 01/10/2022 60033-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0574 Plan of care must include the following Element
G0718 Communication with physicians Element
▼ 05K047 Ameriox, Inc. 14140 Ventura Blvd. Suite 308 Sherman Oaks CA 9 (San Francisco) 03/09/2020 2ZKF11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0574 Plan of care must include the following Element
▼ 05K051 At Home Nursing Services 1378 Corporate Center Parkway, Ste A Santa Rosa CA 9 (San Francisco) 05/19/2022 4EA9B-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0544 Update of the comprehensive assessment Standard
G0578 Conformance with physician orders Standard
▼ 05K053 Maxim Healthcare Services, Inc. 631 River Oaks Parkway San Jose CA 9 (San Francisco) 09/19/2024 62BDE-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0682 Infection Prevention Standard
G0444 State toll free HH telephone hotline Element
▼ 05K053 Maxim Healthcare Services, Inc. 631 River Oaks Parkway San Jose CA 9 (San Francisco) 01/31/2020 KYJH11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0682 Infection Prevention Standard
G0436 Receive all services in plan of care Element
G0536 A review of all current medications Element
G0804 Aides are members of interdisciplinary team Element
G0814 Non-skilled direct observation every 60 days Element
G0948 Responsible for all day-to-day operations Element
▼ 05K059 Maxim Healthcare Services, Inc 28470 Avenue Stanford Suite 280 Santa Clarita CA 9 (San Francisco) 12/22/2023 61C58-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0434 Participate in care Element
G0446 Contact info Federal/State-funded entities Element
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0610 Patients receive education and training Element
G1022 Discharge and transfer summaries Element
▼ 05K064 Accentcare Home Health Of California, Inc 2934 E Garvey Ave S, Suite 210 West Covina CA 9 (San Francisco) 01/12/2018 S26K11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0143 COORDINATION OF PATIENT SERVICES Standard
▼ 05K076 Madison Healthcare Group 21250 Califa St. Unit 113 Woodland Hills CA 9 (San Francisco) 03/24/2023 5F57A-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0612 Written instructions to patient include: Standard
G0434 Participate in care Element
G0536 A review of all current medications Element
G0546 Last 5 days of every 60 days unless: Element
G0584 Verbal orders Element
G1012 Required items in clinical record Element
G1022 Discharge and transfer summaries Element
▼ 05K076 Madison Healthcare Group 21250 Califa St. Unit 113 Woodland Hills CA 9 (San Francisco) 12/19/2019 Z1SX11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0602 Communication with all physicians Element
G0712 Patient, caregiver, and family counseling Element