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
▼ 037226 Apache Healthcare Services Inc 1840 East University Drive Suite 2a Mesa AZ 9 (San Francisco) 04/25/2024 62D60-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
E0021 HHA- Procedures for Follow up Staff/Pts. Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0034 Information on Occupancy/Needs Standard
▼ 037228 Maxim Healthcare Services, Inc. 5151 East Broadway Boulevard, Suite 1200 Tucson AZ 9 (San Francisco) 08/08/2024 63C72-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0848 Compliance with Federal, State, Local Law Condition
▼ 037228 Maxim Healthcare Services, Inc. 5151 East Broadway Boulevard, Suite 1200 Tucson AZ 9 (San Francisco) 11/02/2018 T11Z11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0982 Skilled services furnished Standard
▼ 037229 Maxicare Home Health, Inc. 2432 West Peoria Avenue, Suite 1120 Phoenix AZ 9 (San Francisco) 04/17/2019 Q44911 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0001 Establishment of the Emergency Program (EP) Condition
G0640 Quality assessment/performance improvement Condition
E0004 Develop EP Plan, Review and Update Annually Standard
E0006 Plan Based on All Hazards Risk Assessment Standard
E0009 Local, State, Tribal Collaboration Process Standard
E0017 HHA Comprehensive Assessment in Disaster Standard
E0019 Homebound HHA/Hospice Inform EP Officials Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0029 Development of Communication Plan Standard
E0032 Primary/Alternate Means for Communication Standard
E0033 Methods for Sharing Information Standard
E0034 Information on Occupancy/Needs Standard
E0036 EP Training and Testing Standard
E0037 EP Training Program Standard
E0039 EP Testing Requirements Standard
G0642 Program scope Standard
G0644 Program data Standard
G0660 Executive responsibilities for QAPI Standard
G0584 Verbal orders Element
▼ 037230 Victory Home Care Agency 1212 North Spencer Street, Suite 1 Mesa AZ 9 (San Francisco) 12/05/2024 64CD3-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
E0006 Plan Based on All Hazards Risk Assessment Standard
E0021 HHA- Procedures for Follow up Staff/Pts. Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0030 Names and Contact Information Standard
E0037 EP Training Program Standard
G0684 Infection control Standard
G0686 Infection control education Standard
G1028 Protection of records Standard
▼ 037231 Supreme Home Care, Inc. 1204 East Baseline Road, Suite 102 Tempe AZ 9 (San Francisco) 01/02/2020 M4RC11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0001 Establishment of the Emergency Program (EP) Condition
G0640 Quality assessment/performance improvement Condition
G0680 Infection prevention and control Condition
E0004 Develop EP Plan, Review and Update Annually Standard
E0006 Plan Based on All Hazards Risk Assessment Standard
E0007 EP Program Patient Population Standard
E0009 Local, State, Tribal Collaboration Process Standard
E0017 HHA Comprehensive Assessment in Disaster Standard
E0019 Homebound HHA/Hospice Inform EP Officials Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0029 Development of Communication Plan Standard
E0030 Names and Contact Information Standard
E0032 Primary/Alternate Means for Communication Standard
E0033 Methods for Sharing Information Standard
E0034 Information on Occupancy/Needs Standard
E0036 EP Training and Testing Standard
E0037 EP Training Program Standard
E0039 EP Testing Requirements Standard
G0642 Program scope Standard
G0682 Infection Prevention Standard
▼ 037233 Horizon Home Health Of Phoenix 2720 East Thomas Road, Suite 270b Phoenix AZ 9 (San Francisco) 12/30/2019 UFBH11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0450 Access to auxiliary aids and language service Element
G0980 Primary HHA is responsible for patient care Element
▼ 037234 Team Select Home Care 2999 North 44th Street, Suite 100 Phoenix AZ 9 (San Francisco) 01/31/2025 65180-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0954 Ensures qualified pre-designated person Element
▼ 037235 Firstat Home Health Services,Llc 7330 North 16th Street, Suite C-117 Phoenix AZ 9 (San Francisco) 02/19/2019 4LBW11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0452 Transfer and discharge Standard
G0432 Make complaints to the HHA Element
▼ 037235 Firstat Home Health Services,Llc 7330 North 16th Street, Suite C-117 Phoenix AZ 9 (San Francisco) 10/11/2018 DWS111 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0774 12 hours inservice every 12 months Standard