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
▼ 067063 Mount Evans Hospice Inc 3081 Bergen Peak Dr Evergreen CO 8 (Denver) 10/10/2024 6479B-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0984 In accordance with current clinical practice Element
▼ 067063 Mount Evans Hospice Inc 3081 Bergen Peak Dr Evergreen CO 8 (Denver) 10/21/2021 U3SL11 Focused Infection Control, Other-Fed, Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0600 Coordination of Care Standard
G0514 RN performs assessment Element
G0546 Last 5 days of every 60 days unless: Element
G0602 Communication with all physicians Element
G0800 Services provided by HH aide Element
G1022 Discharge and transfer summaries Element
▼ 067063 Mount Evans Hospice Inc 3081 Bergen Peak Dr Evergreen CO 8 (Denver) 11/08/2018 TV6R11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0682 Infection Prevention Standard
G0710 Provide services in the plan of care Element
G0800 Services provided by HH aide Element
▼ 067080 Interim Healthcare Of Southeastern Colorado Inc 1901 N Union #202 Colorado Springs CO 8 (Denver) 12/12/2025 1DE05A-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0574 Plan of care must include the following Element
G0580 Only as ordered by a physician Element
G1014 Interventions and patient response Element
▼ 067080 Interim Healthcare Of Southeastern Colorado Inc 1901 N Union #202 Colorado Springs CO 8 (Denver) 09/15/2022 4F63E-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0514 RN performs assessment Element
▼ 067080 Interim Healthcare Of Southeastern Colorado Inc 1901 N Union #202 Colorado Springs CO 8 (Denver) 07/07/2021 IY0H11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0590 Promptly alert relevant physician of changes Element
G1014 Interventions and patient response Element
▼ 067080 Interim Healthcare Of Southeastern Colorado Inc 1901 N Union #202 Colorado Springs CO 8 (Denver) 05/02/2019 3DCU11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0578 Conformance with physician orders Standard
▼ 067080 Interim Healthcare Of Southeastern Colorado Inc 1901 N Union #202 Colorado Springs CO 8 (Denver) 12/12/2018 5RJD11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0570 Care planning, coordination, quality of care Condition
G0700 Skilled professional services Condition
G0940 Organization and administration of services Condition
G0958 Clinical manager Standard
G0580 Only as ordered by a physician Element
G0590 Promptly alert relevant physician of changes Element
G0650 Incidence, prevalence, severity of problems Element
G0652 Activities lead to an immediate correction Element
G0710 Provide services in the plan of care Element
G0716 Preparing clinical notes Element
G0718 Communication with physicians Element
G0726 Nursing services supervised by RN Element
G0948 Responsible for all day-to-day operations Element
G0966 Assure patient needs are continually assessed Element
▼ 067084 Columbine Poudre Home Care Llc 915 Centre Ave Ste 2 Fort Collins CO 8 (Denver) 10/15/2020 0DQE11 Focused Infection Control, Other-Fed, Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0706 Interdisciplinary assessment of the patient Element
▼ 067090 Health In Home Services Inc 1673 Fillmore Street Denver CO 8 (Denver) 11/29/2018 D7UI11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0940 Organization and administration of services Condition