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
▼ 137016 Intermountain Home Care Of Cassia 1501 Hiland Avenue. Suite Z Burley ID 10 (Seattle) 01/09/2025 650FB-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
G0432 Make complaints to the HHA Element
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0580 Only as ordered by a physician Element
▼ 137019 Lhcg Xxi Llc 850 W Kathleen Avenue Coeur D Alene ID 10 (Seattle) 02/23/2024 62664-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0570 Care planning, coordination, quality of care Condition
G0578 Conformance with physician orders Standard
G1024 Authentication Standard
G1060 Licensed Practical (Vocational) Nurse Standard
G0590 Promptly alert relevant physician of changes Element
G0608 Coordinate care delivery Element
▼ 137019 Lhcg Xxi Llc 850 W Kathleen Avenue Coeur D Alene ID 10 (Seattle) 04/19/2018 TZST11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0374 Accuracy of encoded OASIS data Standard
G0526 Content of the comprehensive assessment Standard
G0572 Plan of care Standard
G0434 Participate in care Element
G0440 Payment from federally funded programs Element
G0514 RN performs assessment Element
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0580 Only as ordered by a physician Element
G0706 Interdisciplinary assessment of the patient Element
G0718 Communication with physicians Element
G0800 Services provided by HH aide Element
G1022 Discharge and transfer summaries Element
▼ 137049 Bluebird Home Health, Llc 3080 Gentry Way, Ste 203 Meridian ID 10 (Seattle) 12/15/2023 61C28-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0574 Plan of care must include the following Element
▼ 137049 Bluebird Home Health, Llc 3080 Gentry Way, Ste 203 Meridian ID 10 (Seattle) 11/16/2020 7P2W11 Focused Infection Control, Other-Fed, Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0406 Patient rights Condition
G0570 Care planning, coordination, quality of care Condition
G0680 Infection prevention and control Condition
G0750 Home health aide services Condition
E0030 Names and Contact Information Standard
G0372 Encoding and transmitting OASIS Standard
G0374 Accuracy of encoded OASIS data Standard
G0572 Plan of care Standard
G0642 Program scope Standard
G0682 Infection Prevention Standard
G0686 Infection control education Standard
G0768 Competency evaluation Standard
G0798 Home health aide assignments and duties Standard
G0412 Written notice of patient's rights Element
G0416 OASIS privacy notice Element
G0430 Be free from abuse Element
G0438 Have a confidential clinical record Element
G0440 Payment from federally funded programs Element
G0488 Immediate reporting of abuse by all staff Element
G0520 5 calendar days after start of care Element
G0528 Health, psychosocial, functional, cognition Element
G0534 Patient's needs Element
G0536 A review of all current medications Element
G0546 Last 5 days of every 60 days unless: Element
G0574 Plan of care must include the following Element
G0580 Only as ordered by a physician Element
G0588 Reviewed, revised by physician every 60 days Element
G0590 Promptly alert relevant physician of changes Element
G0608 Coordinate care delivery Element
G0706 Interdisciplinary assessment of the patient Element
G0714 Patient and caregiver education Element
G0716 Preparing clinical notes Element
G0804 Aides are members of interdisciplinary team Element
G1022 Discharge and transfer summaries Element
▼ 137058 Franklin County Medical Center Home Care 122 N State St Preston ID 10 (Seattle) 11/30/2023 61A3D-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0406 Patient rights Condition
G0570 Care planning, coordination, quality of care Condition
G0526 Content of the comprehensive assessment Standard
G0702 Services by skilled professionals Standard
G0436 Receive all services in plan of care Element
G0488 Immediate reporting of abuse by all staff Element
G0574 Plan of care must include the following Element
G0590 Promptly alert relevant physician of changes Element
▼ 137058 Franklin County Medical Center Home Care 122 N State St Preston ID 10 (Seattle) 01/27/2021 KUS911 Focused Infection Control, Other-Fed, 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
G0682 Infection Prevention Standard
G0942 Governing body Standard
G0412 Written notice of patient's rights Element
G0440 Payment from federally funded programs Element
G0484 Document complaint and resolution Element
G0488 Immediate reporting of abuse by all staff Element
G0528 Health, psychosocial, functional, cognition Element
G0574 Plan of care must include the following Element
G0580 Only as ordered by a physician Element
▼ 137058 Franklin County Medical Center Home Care 122 N State St Preston ID 10 (Seattle) 02/09/2018 OM0611 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
G0438 Have a confidential clinical record Element
G0528 Health, psychosocial, functional, cognition Element
G0536 A review of all current medications Element
G0550 At discharge Element
G0574 Plan of care must include the following Element
G0590 Promptly alert relevant physician of changes Element
G0598 Discharge plans communication Element
G0606 Integrate all services Element
G0608 Coordinate care delivery Element
G0710 Provide services in the plan of care Element
G0800 Services provided by HH aide Element
G0804 Aides are members of interdisciplinary team Element
G0808 Onsite supervisory visit every 14 days Element
G0946 Administrator appointed by governing body Element
G0952 Ensure that HHA employs qualified personnel Element
G0954 Ensures qualified pre-designated person Element
G0978 Must have a written agreement Element
▼ 137068 Canyon Home Care & Hospice Llc 929 Nw 16th Street Fruitland ID 10 (Seattle) 04/12/2021 6XRV11 Complaint, Focused Infection Control, Other-Fed
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0406 Patient rights Condition
G0424 Exercise of rights Standard
G0442 Written notice for non-covered care Element
▼ 137069 Bear Lake Memorial Hospital Home Health 465 Washington Street Montpelier ID 10 (Seattle) 02/09/2023 5EFD3-H1 Focused Infection Control, 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
G0574 Plan of care must include the following Element
G0722 Participate in HHA-sponsored in-service Element