S&C QCOR HHA 2567s
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HHAs 2567s
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Time Interval

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Provider Characteristics

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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
▼ 157523 Pediatric Infant And Family Home Heatlh Care Specialists Inc. 1512 Burr St Gary IN 5 (Chicago) 01/18/2019 2UPQ12 Complaint, Recertification
Deficiency Tag Deficiency Description Tag Type
G0706 Interdisciplinary assessment of the patient Element
G1012 Required items in clinical record Element
▼ 157523 Pediatric Infant And Family Home Heatlh Care Specialists Inc. 1512 Burr St Gary IN 5 (Chicago) 01/18/2019 LFI211 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0682 Infection Prevention Standard
G0528 Health, psychosocial, functional, cognition Element
G0706 Interdisciplinary assessment of the patient Element
▼ 157523 Pediatric Infant And Family Home Heatlh Care Specialists Inc. 1512 Burr St Gary IN 5 (Chicago) 10/25/2018 2UPQ11 Complaint, 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
G0640 Quality assessment/performance improvement Condition
G0680 Infection prevention and control Condition
G0700 Skilled professional services Condition
G0572 Plan of care Standard
G0682 Infection Prevention Standard
G0684 Infection control Standard
G0942 Governing body Standard
G1024 Authentication Standard
G0436 Receive all services in plan of care Element
G0444 State toll free HH telephone hotline Element
G0514 RN performs assessment Element
G0520 5 calendar days after start of care Element
G0574 Plan of care must include the following Element
G0598 Discharge plans communication Element
G0708 Development and evaluation of plan of care Element
G0710 Provide services in the plan of care Element
G0720 Participate in the HHA's QAPI program; Element
G0800 Services provided by HH aide Element
G0808 Onsite supervisory visit every 14 days Element
G1022 Discharge and transfer summaries Element
▼ 157525 Aaa Hoosier Home Healthcare Specialists Inc 2646 Highway Avenue Highland IN 5 (Chicago) 03/17/2025 65A5C-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0510 Comprehensive Assessment of Patients Condition
G0570 Care planning, coordination, quality of care Condition
G0544 Update of the comprehensive assessment Standard
G0572 Plan of care Standard
G0528 Health, psychosocial, functional, cognition Element
G0536 A review of all current medications Element
G0538 Primary caregiver(s), if any Element
G0574 Plan of care must include the following Element
G0580 Only as ordered by a physician Element
G0590 Promptly alert relevant physician of changes Element
G0592 Revised plan of care Element
G0800 Services provided by HH aide Element
G0818 HH aide supervision elements Element
▼ 157525 Aaa Hoosier Home Healthcare Specialists Inc 2646 Highway Avenue Highland IN 5 (Chicago) 05/14/2024 62845-H2 Complaint
Deficiency Tag Deficiency Description Tag Type
G0598 Discharge plans communication Element
▼ 157525 Aaa Hoosier Home Healthcare Specialists Inc 2646 Highway Avenue Highland IN 5 (Chicago) 03/22/2024 62845-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0406 Condition of Participation: Patient rights. Condition
G0510 Comprehensive Assessment of Patients Condition
G0570 Care planning, coordination, quality of care Condition
G0640 Quality assessment/performance improvement Condition
G0750 Home health aide services Condition
E0017 HHA Comprehensive Assessment in Disaster Standard
E0021 HHA- Procedures for Follow up Staff/Pts. Standard
E0029 Development of Communication Plan Standard
G0372 Encoding and transmitting OASIS Standard
G0562 Discharge Planning Standard
G0564 Discharge or Transfer Summary Content Standard
G0572 Plan of care Standard
G0682 Infection Prevention Standard
G0686 Infection control education Standard
G0768 Competency evaluation Standard
G0798 Home health aide assignments and duties Standard
G1024 Authentication Standard
G0428 Property and person treated with respect Element
G0434 Participate in care Element
G0458 Outcomes/goals have been achieved Element
G0466 Make efforts to resolve the problem(s) Element
G0468 Provide contact info other services Element
G0470 Document efforts to resolve problems Element
G0514 RN performs assessment Element
G0528 Health, psychosocial, functional, cognition Element
G0536 A review of all current medications Element
G0538 Primary caregiver(s), if any Element
G0548 Within 48 hours of the patient's return 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
G0606 Integrate all services Element
G0710 Provide services in the plan of care Element
G0716 Preparing clinical notes Element
G0800 Services provided by HH aide Element
G0818 HH aide supervision elements Element
G0948 Responsible for all day-to-day operations Element
G0964 Coordinate referrals; Element
G0978 Must have a written agreement Element
G0984 In accordance with current clinical practice Element
G1012 Required items in clinical record Element
G1022 Discharge and transfer summaries Element
▼ 157525 Aaa Hoosier Home Healthcare Specialists Inc 2646 Highway Avenue Highland IN 5 (Chicago) 05/20/2022 387E1-H2 Complaint, Recertification
Deficiency Tag Deficiency Description Tag Type
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0716 Preparing clinical notes Element
▼ 157525 Aaa Hoosier Home Healthcare Specialists Inc 2646 Highway Avenue Highland IN 5 (Chicago) 04/08/2022 387E1-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
G0680 Infection prevention and control Condition
G0374 Accuracy of encoded OASIS data Standard
G0682 Infection Prevention Standard
G0684 Infection control Standard
G0687 COVID-19 Vaccination of Home Health Agency staff Standard
G1024 Authentication Standard
G0576 All orders recorded in plan of care Element
G0580 Only as ordered by a physician Element
G0606 Integrate all services Element
G0616 Patient medication schedule/instructions Element
G0800 Services provided by HH aide Element
▼ 157525 Aaa Hoosier Home Healthcare Specialists Inc 2646 Highway Avenue Highland IN 5 (Chicago) 07/24/2019 PF1S11 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
G0798 Home health aide assignments and duties Standard
G0528 Health, psychosocial, functional, cognition Element
G0574 Plan of care must include the following Element
G0706 Interdisciplinary assessment of the patient Element
G0710 Provide services in the plan of care Element
▼ 157529 Eh Home Health Of The Midwest, Llc 1449 Kimber Lane Ste 101 Evansville IN 5 (Chicago) 12/14/2023 61AD9-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
G0612 Written instructions to patient include: Standard
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0948 Responsible for all day-to-day operations Element