S&C QCOR HHA 2567s
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HHAs 2567s
Selection Criteria ▸

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
▼ 157551 Interim Healthcare Of Se Indiana Inc 3200 North National Road Columbus IN 5 (Chicago) 10/18/2021 19768-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0470 Document efforts to resolve problems Element
G0710 Provide services in the plan of care Element
▼ 157551 Interim Healthcare Of Se Indiana Inc 3200 North National Road Columbus IN 5 (Chicago) 11/20/2019 23FH11 Complaint, Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0004 Develop EP Plan, Review and Update Annually Standard
E0009 Local, State, Tribal Collaboration Process Standard
G0572 Plan of care Standard
G0574 Plan of care must include the following Element
▼ 157552 Joy Health Services Llc 2825 E 96th St Indianapolis IN 5 (Chicago) 07/25/2023 5FAB5-H2 Complaint
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0004 Develop EP Plan, Review and Update Annually Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0030 Names and Contact Information Standard
E0039 EP Testing Requirements Standard
G0682 Infection Prevention Standard
G0484 Document complaint and resolution Element
G0528 Health, psychosocial, functional, cognition Element
G0530 Strengths, goals, and care preferences Element
G0534 Patient's needs Element
G0574 Plan of care must include the following Element
G0592 Revised plan of care Element
G0606 Integrate all services Element
▼ 157552 Joy Health Services Llc 2825 E 96th St Indianapolis IN 5 (Chicago) 09/23/2020 V9LP11 Complaint, 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
G0706 Interdisciplinary assessment of the patient Element
▼ 157553 In Homecare Network North Llc 1400 E Mcgalliard Rd Muncie IN 5 (Chicago) 01/25/2024 614A6-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
G0434 Participate in care Element
G0514 RN performs assessment Element
G0574 Plan of care must include the following Element
G0580 Only as ordered by a physician Element
G0584 Verbal orders Element
G0598 Discharge plans communication Element
G1022 Discharge and transfer summaries Element
▼ 157553 In Homecare Network North Llc 1400 E Mcgalliard Rd Muncie IN 5 (Chicago) 08/12/2021 DUGW11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0954 Ensures qualified pre-designated person Element
▼ 157553 In Homecare Network North Llc 1400 E Mcgalliard Rd Muncie IN 5 (Chicago) 05/31/2018 264311 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
G0798 Home health aide assignments and duties Standard
G0528 Health, psychosocial, functional, cognition Element
G0530 Strengths, goals, and care preferences 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
G0952 Ensure that HHA employs qualified personnel Element
▼ 157554 In Homecare Network North Llc 2509 W 2nd Street Marion IN 5 (Chicago) 03/17/2025 65883-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
G0564 Discharge or Transfer Summary Content Standard
G0682 Infection Prevention Standard
G0520 5 calendar days after start of care 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
G0706 Interdisciplinary assessment of the patient Element
▼ 157554 In Homecare Network North Llc 2509 W 2nd Street Marion IN 5 (Chicago) 03/22/2022 3867B-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
G0572 Plan of care Standard
G0687 COVID-19 Vaccination of Home Health Agency staff Standard
G0528 Health, psychosocial, functional, cognition Element
G0574 Plan of care must include the following Element
G0590 Promptly alert relevant physician of changes Element
G0602 Communication with all physicians Element
G0800 Services provided by HH aide Element
▼ 157554 In Homecare Network North Llc 2509 W 2nd Street Marion IN 5 (Chicago) 05/31/2019 S52D11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0350 Release of patient identifiable OASIS info. Condition
G0940 Organization and administration of services Condition
G1008 Clinical records Condition
G0942 Governing body Standard
G1028 Protection of records Standard
G0438 Have a confidential clinical record Element