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
▼ 157529 Eh Home Health Of The Midwest, Llc 1449 Kimber Lane Ste 101 Evansville IN 5 (Chicago) 01/19/2021 409U11 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
E0024 Policies/Procedures-Volunteers and Staffing Standard
G0682 Infection Prevention Standard
▼ 157529 Eh Home Health Of The Midwest, Llc 1449 Kimber Lane Ste 101 Evansville IN 5 (Chicago) 03/26/2018 1C0U11 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
G0580 Only as ordered by a physician Element
G0706 Interdisciplinary assessment of the patient Element
G0710 Provide services in the plan of care Element
▼ 157530 Centerwell Health Services (Usa) Llc 2901 Ohio Boulevard Suite 210-1 Terre Haute IN 5 (Chicago) 04/10/2018 VCF311 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
G0514 RN performs assessment Element
G0536 A review of all current medications 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
G0984 In accordance with current clinical practice Element
▼ 157533 Community Home Health Care Services, Llc 240 Commerce Square Drive Michigan City IN 5 (Chicago) 08/06/2021 6Q0V12 Complaint
Deficiency Tag Deficiency Description Tag Type
G1024 Authentication Standard
G0534 Patient's needs Element
G0536 A review of all current medications Element
G0580 Only as ordered by a physician Element
G0948 Responsible for all day-to-day operations Element
▼ 157533 Community Home Health Care Services, Llc 240 Commerce Square Drive Michigan City IN 5 (Chicago) 02/18/2021 6Q0V11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0940 Organization and administration of services Condition
G0572 Plan of care Standard
G0682 Infection Prevention Standard
G0798 Home health aide assignments and duties Standard
G0574 Plan of care must include the following Element
G0590 Promptly alert relevant physician of changes Element
G0606 Integrate all services Element
G0614 Visit schedule Element
G0856 Officer, a director, agent, managing employee Element
▼ 157536 The Methodist Hospitals Inc 303 E 89th Avenue, Suite A, Room 117 Merrillville IN 5 (Chicago) 12/18/2024 64E36-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
G0644 Program data Standard
G0646 Program activities Standard
G0682 Infection Prevention Standard
G0460 Patient refuses services Element
G0464 Advise the patient of discharge for cause Element
G0514 RN performs assessment Element
G0520 5 calendar days after start of care 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
G0580 Only as ordered by a physician Element
G0706 Interdisciplinary assessment of the patient Element
G0716 Preparing clinical notes Element
G0808 Onsite supervisory visit every 14 days Element
▼ 157536 The Methodist Hospitals Inc 303 E 89th Avenue, Suite A, Room 117 Merrillville IN 5 (Chicago) 04/08/2022 382AD-H2 Recertification
Deficiency Tag Deficiency Description Tag Type
G0580 Only as ordered by a physician Element
▼ 157536 The Methodist Hospitals Inc 303 E 89th Avenue, Suite A, Room 117 Merrillville IN 5 (Chicago) 01/26/2022 382AD-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0560 Discharge Planning Condition
E0017 HHA Comprehensive Assessment in Disaster Standard
E0030 Names and Contact Information Standard
G0374 Accuracy of encoded OASIS data Standard
G0562 Discharge Planning Standard
G0564 Discharge or Transfer Summary Content Standard
G0572 Plan of care Standard
G0768 Competency evaluation Standard
G0436 Receive all services in plan of care Element
G0454 HHA can no longer meet the patient's needs Element
G0574 Plan of care must include the following Element
G0590 Promptly alert relevant physician of changes Element
G0604 Integrate all orders Element
G0608 Coordinate care delivery Element
G0614 Visit schedule Element
G0616 Patient medication schedule/instructions Element
G0618 Treatments and therapy services Element
G0710 Provide services in the plan of care Element
G0716 Preparing clinical notes Element
G1022 Discharge and transfer summaries Element
▼ 157536 The Methodist Hospitals Inc 303 E 89th Avenue, Suite A, Room 117 Merrillville IN 5 (Chicago) 03/31/2021 2GKX11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G1024 Authentication Standard
G0574 Plan of care must include the following Element
G0576 All orders recorded in plan of care Element
G0590 Promptly alert relevant physician of changes Element
▼ 157536 The Methodist Hospitals Inc 303 E 89th Avenue, Suite A, Room 117 Merrillville IN 5 (Chicago) 06/11/2019 H1E411 Complaint, Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0942 Governing body Standard
G0574 Plan of care must include the following Element
G0710 Provide services in the plan of care Element
G1018 Contact information for the patient Element