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
▼ 157573 American Home Health Services Inc 7895 Broadway Avenue, Suite G-A Merrillville IN 5 (Chicago) 01/09/2025 6506E-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
G0640 Quality assessment/performance improvement Condition
G0680 Infection prevention and control Condition
G0544 Update of the comprehensive assessment Standard
G0572 Plan of care Standard
G0682 Infection Prevention Standard
G0684 Infection control Standard
G0798 Home health aide assignments and duties Standard
G1024 Authentication Standard
G0434 Participate in care Element
G0460 Patient refuses services Element
G0464 Advise the patient of discharge for cause 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
G0606 Integrate all services Element
G0716 Preparing clinical notes Element
G0800 Services provided by HH aide Element
G0818 HH aide supervision elements Element
G0960 Make patient and personnel assignments, Element
G0984 In accordance with current clinical practice Element
G1022 Discharge and transfer summaries Element
▼ 157573 American Home Health Services Inc 7895 Broadway Avenue, Suite G-A Merrillville IN 5 (Chicago) 03/31/2022 38490-H2 Focused Infection Control, Recertification
Deficiency Tag Deficiency Description Tag Type
G1024 Authentication Standard
G0800 Services provided by HH aide Element
▼ 157573 American Home Health Services Inc 7895 Broadway Avenue, Suite G-A Merrillville IN 5 (Chicago) 02/18/2022 38490-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
E0001 Establishment of the Emergency Program (EP) Condition
G0680 Infection prevention and control Condition
E0004 Develop EP Plan, Review and Update Annually Standard
E0006 Plan Based on All Hazards Risk Assessment Standard
E0017 HHA Comprehensive Assessment in Disaster Standard
E0031 Emergency Officials Contact Information Standard
G0682 Infection Prevention Standard
G0687 COVID-19 Vaccination of Home Health Agency staff Standard
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0592 Revised plan of care Element
G0614 Visit schedule Element
G0616 Patient medication schedule/instructions Element
G0618 Treatments and therapy services Element
G0772 Documentation of competency evaluation Element
▼ 157576 Central Home Health Services Inc 5699 E 71st St Ste 2b Indianapolis IN 5 (Chicago) 08/19/2021 L0TP11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
▼ 157576 Central Home Health Services Inc 5699 E 71st St Ste 2b Indianapolis IN 5 (Chicago) 09/18/2019 KDPF12 Recertification
Deficiency Tag Deficiency Description Tag Type
G0948 Responsible for all day-to-day operations Element
G1020 Contact info for primary care practitioner Element
▼ 157576 Central Home Health Services Inc 5699 E 71st St Ste 2b Indianapolis IN 5 (Chicago) 07/26/2019 KDPF11 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
G0750 Home health aide services Condition
G0512 Standard: Initial assessment visit. Standard
G0572 Plan of care Standard
G0682 Infection Prevention Standard
G1024 Authentication Standard
G0410 Information to patient 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
G0606 Integrate all services Element
G0616 Patient medication schedule/instructions Element
G0706 Interdisciplinary assessment of the patient Element
G0714 Patient and caregiver education Element
G0754 A qualified HH aide successfully completed: Element
G0772 Documentation of competency evaluation Element
G0800 Services provided by HH aide Element
G1012 Required items in clinical record Element
▼ 157578 Amedisys Sp-In Llc 1332 W Arch Haven Ave Ste E Bloomington IN 5 (Chicago) 10/06/2021 1970D-H1 Complaint, Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0700 Skilled professional services Condition
G0940 Organization and administration of services Condition
E0039 EP Testing Requirements Standard
G0578 Conformance with physician orders Standard
G0600 Coordination of Care Standard
G0682 Infection Prevention Standard
G0852 Information to the state survey agency Standard
G0942 Governing body Standard
G0970 Parent-branch relationship Standard
G1024 Authentication Standard
G0416 OASIS privacy notice Element
G0442 Written notice for non-covered care Element
G0574 Plan of care must include the following Element
G0590 Promptly alert relevant physician of changes Element
G0706 Interdisciplinary assessment of the patient Element
G0710 Provide services in the plan of care Element
G0716 Preparing clinical notes Element
G0718 Communication with physicians Element
G0946 Administrator appointed by governing body Element
G0948 Responsible for all day-to-day operations Element
G0954 Ensures qualified pre-designated person Element
G0966 Assure patient needs are continually assessed Element
G0974 Direct support and administrative control Element
G0984 In accordance with current clinical practice Element
G1014 Interventions and patient response Element
▼ 157578 Amedisys Sp-In Llc 1332 W Arch Haven Ave Ste E Bloomington IN 5 (Chicago) 02/02/2021 83U511 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
G0988 Institutional planning Standard
G0946 Administrator appointed by governing body Element
G0954 Ensures qualified pre-designated person Element
G0974 Direct support and administrative control Element
▼ 157578 Amedisys Sp-In Llc 1332 W Arch Haven Ave Ste E Bloomington IN 5 (Chicago) 03/22/2018 3WUS11 Complaint, 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
G0478 Investigate complaints made by patient Element
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
G0598 Discharge plans communication Element
G0616 Patient medication schedule/instructions Element
G0706 Interdisciplinary assessment of the patient Element
G0710 Provide services in the plan of care Element
G1022 Discharge and transfer summaries Element
▼ 157579 Cj's Home Care Inc 1002 Central Avenue Anderson IN 5 (Chicago) 11/01/2024 648AF-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0372 Encoding and transmitting OASIS Standard
G0414 HHA administrator contact information Element