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
▼ 109333 Mobile Personal Services Inc 2507 Seven Springs Blvd Trinity FL 4 (Atlanta) 05/22/2018 6OZZ11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0436 Receive all services in plan of care Element
G0590 Promptly alert relevant physician of changes Element
▼ 109337 Active Home Health Care Services Llc 5589 Okeechobee Blvd West Palm Beach FL 4 (Atlanta) 08/07/2025 1D2E79-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0808 Onsite supervisory visit every 14 days Element
G1012 Required items in clinical record Element
▼ 109337 Active Home Health Care Services Llc 5589 Okeechobee Blvd West Palm Beach FL 4 (Atlanta) 06/12/2019 FVRL11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0598 Discharge plans communication Element
G1014 Interventions and patient response Element
▼ 109341 Ml Home Care Inc 14850 Sw 26th St Ste 205 Miami FL 4 (Atlanta) 08/28/2018 NM8Q11 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
E0006 Plan Based on All Hazards Risk Assessment Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0030 Names and Contact Information Standard
E0037 EP Training Program Standard
E0039 EP Testing Requirements Standard
G0982 Skilled services furnished Standard
G0536 A review of all current medications Element
G0582 Influenza and pneumococcal vaccines Element
G0818 HH aide supervision elements Element
▼ 109346 Abella Yose Care Service Inc 5901 Nw 151st St Ste 102 Miami Lakes FL 4 (Atlanta) 09/25/2019 NOL711 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0418 Patient's or legal representative's signature Element
G0422 Written notice within 4 business days Element
G0434 Participate in care Element
G0440 Payment from federally funded programs Element
G0484 Document complaint and resolution Element
G0574 Plan of care must include the following Element
G0800 Services provided by HH aide Element
▼ 109346 Abella Yose Care Service Inc 5901 Nw 151st St Ste 102 Miami Lakes FL 4 (Atlanta) 04/09/2019 EURM11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0768 Competency evaluation Standard
G0814 Non-skilled direct observation every 60 days Element
▼ 109349 Professional Nurses Homecare Inc 2750 N 29th Ave Ste 202b Hollywood FL 4 (Atlanta) 08/22/2019 TO3Q11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0009 Local, State, Tribal Collaboration Process Standard
G0434 Participate in care Element
▼ 109371 Trilogy Home Healthcare Sw Fl Inc 5971 Cattleridge Blvd Ste 200 Sarasota FL 4 (Atlanta) 09/25/2018 5UPZ11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G1012 Required items in clinical record Element
▼ 109377 Home Health Services Of Broward 10794 Pines Blvd Ste 201 Pembroke Pines FL 4 (Atlanta) 10/10/2019 TD9F11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0596 Revisions communicated to patient and MDs Element
G0598 Discharge plans communication Element
▼ 109383 Lifetime Home Health Care Corp 13335 Sw 124th St Ste 103 Miami FL 4 (Atlanta) 03/29/2019 F8RW11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0426 Rights of the patient Standard
G0724 Supervise skilled professional assistants Standard
G0434 Participate in care Element
G0608 Coordinate care delivery Element
G0716 Preparing clinical notes Element
G0728 Rehab services supervised by PT, OT Element
G0962 Coordinate patient care Element
G1012 Required items in clinical record Element