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
▼ 117802 Quality One Home Health Agency, Llc 3500 N Decatur Road Suite 106 Scottdale GA 4 (Atlanta) 08/28/2025 1D5603-H1 Complaint, Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0372 Encoding and transmitting OASIS Standard
▼ 127022 Kaiser Foundation Hospitals 2828 Pa'A Street Honolulu HI 9 (San Francisco) 10/06/2023 611DD-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0512 Standard: Initial assessment visit. Standard
G0572 Plan of care Standard
▼ 127023 Kaiser Home Health Agency Maui 80 Mahalani Street Wailuku HI 9 (San Francisco) 03/03/2023 5F1ED-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G1024 Authentication Standard
G0514 RN performs assessment Element
G0592 Revised plan of care Element
▼ 127025 Prime Care Services Hawaii Inc 2228 Liliha St, Ste 205 Honolulu HI 9 (San Francisco) 06/28/2024 63695-H1 Recertification
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
G0682 Infection Prevention Standard
G1024 Authentication Standard
G0514 RN performs assessment Element
G0576 All orders recorded in plan of care Element
G0984 In accordance with current clinical practice Element
G1022 Discharge and transfer summaries Element
▼ 127025 Prime Care Services Hawaii Inc 2228 Liliha St, Ste 205 Honolulu HI 9 (San Francisco) 02/01/2018 VQ6J11 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
G0536 A review of all current medications Element
▼ 127027 West Hawaii Home Health Svcs 81-990 Halekii St, Ste 100 Kealakekua HI 9 (San Francisco) 01/09/2020 6OX011 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0510 Comprehensive Assessment of Patients Condition
G0640 Quality assessment/performance improvement Condition
G0940 Organization and administration of services Condition
G0642 Program scope Standard
G0660 Executive responsibilities for QAPI Standard
G0942 Governing body Standard
G0514 RN performs assessment Element
G0528 Health, psychosocial, functional, cognition Element
G0948 Responsible for all day-to-day operations Element
▼ 127312 B.C.P., Inc. 1255 Kilauea Avenue, Ste 200 Hilo HI 9 (San Francisco) 08/04/2021 XH6D11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0574 Plan of care must include the following Element
G0576 All orders recorded in plan of care Element
▼ 137006 Saint Alphonsus Home Health And Hospice Llc 1450 S Eagle Flight Way Ste 100 Boise ID 10 (Seattle) 06/07/2018 PEI511 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0434 Participate in care Element
G0464 Advise the patient of discharge for cause Element
G0470 Document efforts to resolve problems Element
G0574 Plan of care must include the following Element
G0606 Integrate all services Element
▼ 137014 Idaho Home Health & Hospice 722 N College Rd 150 Twin Falls ID 10 (Seattle) 02/08/2024 62348-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G1024 Authentication Standard
G0534 Patient's needs Element
G0598 Discharge plans communication Element
▼ 137014 Idaho Home Health & Hospice 722 N College Rd 150 Twin Falls ID 10 (Seattle) 08/16/2018 3V0R11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0700 Skilled professional services Condition
G0572 Plan of care Standard
G0412 Written notice of patient's rights Element
G0434 Participate in care Element
G0440 Payment from federally funded programs Element
G0536 A review of all current medications Element
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
G0708 Development and evaluation of plan of care Element
G0710 Provide services in the plan of care Element
G0714 Patient and caregiver education Element
G0718 Communication with physicians Element
G0726 Nursing services supervised by RN Element
G0730 Medical social services supervised by MSW Element