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
▼ 157221 Amedisys Sp-In Llc 303 Quartermaster Ct Jeffersonville IN 5 (Chicago) 02/20/2020 HRMB11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0940 Organization and administration of services Condition
G0572 Plan of care Standard
G0644 Program data Standard
G0942 Governing body Standard
G0988 Institutional planning Standard
G0460 Patient refuses services Element
G0528 Health, psychosocial, functional, cognition Element
G0590 Promptly alert relevant physician of changes Element
G0608 Coordinate care delivery Element
G0616 Patient medication schedule/instructions Element
G0622 Name/contact information of clinical manager Element
G0710 Provide services in the plan of care Element
G0714 Patient and caregiver education Element
G0946 Administrator appointed by governing body Element
G0948 Responsible for all day-to-day operations Element
G0954 Ensures qualified pre-designated person Element
G0962 Coordinate patient care Element
▼ 157230 Caregivers, Inc 8777 Purdue, Suite 108 Indianapolis IN 5 (Chicago) 01/08/2026 1DF82E-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
G0680 Infection prevention and control Condition
G0372 Encoding and transmitting OASIS Standard
G0572 Plan of care Standard
G0654 Track adverse patient events Standard
G0682 Infection Prevention Standard
G0684 Infection control Standard
G0798 Home health aide assignments and duties Standard
G0580 Only as ordered by a physician Element
G0590 Promptly alert relevant physician of changes Element
G0606 Integrate all services Element
G0614 Visit schedule Element
G0656 Improvements are sustained Element
G0714 Patient and caregiver education Element
G0948 Responsible for all day-to-day operations Element
G0966 Assure patient needs are continually assessed Element
▼ 157230 Caregivers, Inc 8777 Purdue, Suite 108 Indianapolis IN 5 (Chicago) 11/07/2022 5E254-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0526 Content of the comprehensive assessment Standard
G0572 Plan of care Standard
G0682 Infection Prevention Standard
G0414 HHA administrator contact information Element
G0536 A review of all current medications Element
G0602 Communication with all physicians Element
G0726 Nursing services supervised by RN Element
▼ 157230 Caregivers, Inc 8777 Purdue, Suite 108 Indianapolis IN 5 (Chicago) 03/16/2020 Y56411 Complaint, Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0039 EP Testing Requirements Standard
G0512 Standard: Initial assessment visit. Standard
G0798 Home health aide assignments and duties Standard
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0590 Promptly alert relevant physician of changes Element
G0800 Services provided by HH aide Element
G0808 Onsite supervisory visit every 14 days Element
G0814 Non-skilled direct observation every 60 days Element
▼ 157231 Reid-Anc Home Care Services Llc 2220 Chester Blvd Richmond IN 5 (Chicago) 09/17/2025 1D17A0-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0536 A review of all current medications Element
G0592 Revised plan of care Element
G0606 Integrate all services Element
G0710 Provide services in the plan of care Element
▼ 157231 Reid-Anc Home Care Services Llc 2220 Chester Blvd Richmond IN 5 (Chicago) 03/16/2023 5F2E1-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0031 Emergency Officials Contact Information Standard
G0682 Infection Prevention Standard
G0687 COVID-19 Vaccination of Home Health Agency staff Standard
G1030 Retrieval of records Standard
G0536 A review of all current medications Element
G0710 Provide services in the plan of care Element
▼ 157231 Reid-Anc Home Care Services Llc 2220 Chester Blvd Richmond IN 5 (Chicago) 03/22/2018 NY3R11 Complaint, 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
G0682 Infection Prevention Standard
G0574 Plan of care must include the following Element
G0590 Promptly alert relevant physician of changes Element
G0710 Provide services in the plan of care Element
▼ 157249 Associated Homecare Inc 2701 Beech St Ste J Valparaiso IN 5 (Chicago) 05/17/2018 KG8J11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0406 Patient rights Condition
G0570 Care planning, coordination, quality of care Condition
G0700 Skilled professional services Condition
G0750 Home health aide services Condition
G0940 Organization and administration of services Condition
G0572 Plan of care Standard
G0682 Infection Prevention Standard
G0684 Infection control Standard
G0768 Competency evaluation Standard
G0798 Home health aide assignments and duties Standard
G1024 Authentication Standard
G0428 Property and person treated with respect Element
G0430 Be free from abuse Element
G0432 Make complaints to the HHA Element
G0434 Participate in care Element
G0436 Receive all services in plan of care Element
G0440 Payment from federally funded programs Element
G0444 State toll free HH telephone hotline Element
G0464 Advise the patient of discharge for cause Element
G0466 Make efforts to resolve the problem(s) Element
G0474 HHA ceases to operate Element
G0478 Investigate complaints made by patient Element
G0480 Treatment or care Element
G0482 Mistreatment, neglect or abuse Element
G0484 Document complaint and resolution Element
G0530 Strengths, goals, and care preferences 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
G0584 Verbal orders Element
G0588 Reviewed, revised by physician every 60 days Element
G0598 Discharge plans communication Element
G0606 Integrate all services Element
G0608 Coordinate care delivery Element
G0614 Visit schedule Element
G0620 Other pertinent instructions 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
G0800 Services provided by HH aide Element
G0804 Aides are members of interdisciplinary team Element
G0808 Onsite supervisory visit every 14 days Element
G0818 HH aide supervision elements Element
G0822 Ensuring the overall quality of care provided Element
G0824 Supervising HH aide services Element
G0948 Responsible for all day-to-day operations Element
G0960 Make patient and personnel assignments, Element
G0968 Assure implementation of plan of care Element
G0974 Direct support and administrative control Element
G0980 Primary HHA is responsible for patient care Element
G1016 Goals in the patient's plans of care Element
▼ 157252 Alliance Home Health Services Llc 5455 Harrison Park La Indianapolis IN 5 (Chicago) 04/08/2022 384BD-H2 Recertification
Deficiency Tag Deficiency Description Tag Type
G0802 Duties of a HH aide Element
▼ 157252 Alliance Home Health Services Llc 5455 Harrison Park La Indianapolis IN 5 (Chicago) 02/23/2022 384BD-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
G1008 Clinical records Condition
G0572 Plan of care Standard
G0682 Infection Prevention Standard
G0686 Infection control education Standard
G0436 Receive all services in plan of care Element
G0580 Only as ordered by a physician Element
G0584 Verbal orders Element
G0588 Reviewed, revised by physician every 60 days Element
G0710 Provide services in the plan of care Element
G0800 Services provided by HH aide Element
G0948 Responsible for all day-to-day operations Element