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
▼ 047122 Arkansas Home Health Providers-Iii, Llc 1227 State Hwy 77 Suite E 2 Marion AR 6 (Dallas) 06/01/2018 8ZER11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0570 Care planning, coordination, quality of care Condition
G0544 Update of the comprehensive assessment Standard
G0528 Health, psychosocial, functional, cognition Element
G0536 A review of all current medications Element
G0590 Promptly alert relevant physician of changes Element
G0606 Integrate all services Element
▼ 047127 Delta Memorial Hospital Hha 1020 Hwy 165 South Dumas AR 6 (Dallas) 10/17/2018 ROLQ11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0612 Written instructions to patient include: Standard
G0710 Provide services in the plan of care Element
▼ 047128 Arkansas Homecare Of Forrest City, Llc 4200 N Washington Street, Suite 1 Forrest City AR 6 (Dallas) 12/08/2022 5E819-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0684 Infection control Standard
G0536 A review of all current medications Element
▼ 047128 Arkansas Homecare Of Forrest City, Llc 4200 N Washington Street, Suite 1 Forrest City AR 6 (Dallas) 08/21/2019 DGEW11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0512 Standard: Initial assessment visit. Standard
G0572 Plan of care Standard
G0520 5 calendar days after start of care Element
G0536 A review of all current medications Element
G0592 Revised plan of care Element
G1022 Discharge and transfer summaries Element
▼ 047133 Mena Medical Center Home Health, Llc 605 Magnolia Avenue Mena AR 6 (Dallas) 08/10/2018 5WXY11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0436 Receive all services in plan of care Element
▼ 047134 Eureka Springs Hospital Homecare, Llc 115 W. Industrial Park Rd, Ste 7 Harrison AR 6 (Dallas) 04/18/2025 66006-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0536 A review of all current medications Element
▼ 047134 Eureka Springs Hospital Homecare, Llc 115 W. Industrial Park Rd, Ste 7 Harrison AR 6 (Dallas) 09/01/2022 4F4E5-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0616 Patient medication schedule/instructions Element
G1022 Discharge and transfer summaries Element
▼ 047134 Eureka Springs Hospital Homecare, Llc 115 W. Industrial Park Rd, Ste 7 Harrison AR 6 (Dallas) 05/10/2019 H1RE11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0578 Conformance with physician orders Standard
G0682 Infection Prevention Standard
G0536 A review of all current medications Element
G0726 Nursing services supervised by RN Element
G1014 Interventions and patient response Element
▼ 047135 Home Health Professionals Inc 2222 Spence Circle Jonesboro AR 6 (Dallas) 10/11/2024 646F1-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0372 Encoding and transmitting OASIS Standard
G0536 A review of all current medications Element
▼ 047135 Home Health Professionals Inc 2222 Spence Circle Jonesboro AR 6 (Dallas) 02/09/2022 3825C-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0570 Care planning, coordination, quality of care Condition
G0578 Conformance with physician orders Standard
G0536 A review of all current medications Element
G0580 Only as ordered by a physician Element
G0590 Promptly alert relevant physician of changes Element