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
▼ 157581 Assured Home Healthcare Inc 1947 Harder Ct Ste B Schererville IN 5 (Chicago) 11/23/2021 37EC5-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0682 Infection Prevention Standard
G1024 Authentication Standard
G0534 Patient's needs Element
G0574 Plan of care must include the following Element
G0576 All orders recorded in plan of care Element
G0614 Visit schedule Element
G0656 Improvements are sustained Element
G0718 Communication with physicians Element
G0800 Services provided by HH aide Element
G1014 Interventions and patient response Element
▼ 157581 Assured Home Healthcare Inc 1947 Harder Ct Ste B Schererville IN 5 (Chicago) 05/17/2019 8CRM11 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
E0024 Policies/Procedures-Volunteers and Staffing Standard
G0682 Infection Prevention Standard
G0850 Disclosure of ownership and management info. Standard
▼ 157582 Innovative Senior Care Home Health Of Indianapolis Llc 6640 Parkdale Pl Suite S1 Indianapolis IN 5 (Chicago) 05/18/2023 5FC97-H1 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
▼ 157584 Saint Joseph - Anc Home Care Services, Llc 516 E Lewis & Clark Pkwy Ste 101 Clarksville IN 5 (Chicago) 02/24/2026 1E467E-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0682 Infection Prevention Standard
G0580 Only as ordered by a physician Element
▼ 157584 Saint Joseph - Anc Home Care Services, Llc 516 E Lewis & Clark Pkwy Ste 101 Clarksville IN 5 (Chicago) 05/22/2024 63157-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0514 RN performs assessment Element
G0584 Verbal orders Element
▼ 157584 Saint Joseph - Anc Home Care Services, Llc 516 E Lewis & Clark Pkwy Ste 101 Clarksville IN 5 (Chicago) 08/23/2018 9FG111 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
G0798 Home health aide assignments and duties Standard
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
▼ 157586 Community Home Health Network Of Indiana Llc 2130 W Sycamore Ste 240 Kokomo IN 5 (Chicago) 09/02/2020 HDKM11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0370 Reporting OASIS information Condition
G0406 Patient rights Condition
G0510 Comprehensive Assessment of Patients Condition
G0570 Care planning, coordination, quality of care Condition
G0680 Infection prevention and control Condition
G0940 Organization and administration of services Condition
G0372 Encoding and transmitting OASIS Standard
G0374 Accuracy of encoded OASIS data Standard
G0572 Plan of care Standard
G0682 Infection Prevention Standard
G0684 Infection control Standard
G0798 Home health aide assignments and duties Standard
G0942 Governing body Standard
G1024 Authentication Standard
G0414 HHA administrator contact information Element
G0430 Be free from abuse Element
G0478 Investigate complaints made by patient Element
G0514 RN performs assessment Element
G0520 5 calendar days after start of care Element
G0528 Health, psychosocial, functional, cognition Element
G0530 Strengths, goals, and care preferences 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
G0576 All orders recorded in plan of care Element
G0580 Only as ordered by a physician Element
G0584 Verbal orders Element
G0590 Promptly alert relevant physician of changes Element
G0592 Revised plan of care Element
G0602 Communication with all physicians Element
G0606 Integrate all services Element
G0610 Patients receive education and training Element
G0614 Visit schedule Element
G0616 Patient medication schedule/instructions Element
G0618 Treatments and therapy services Element
G0620 Other pertinent instructions Element
G0622 Name/contact information of clinical manager Element
G0706 Interdisciplinary assessment of the patient Element
G0714 Patient and caregiver education Element
G0716 Preparing clinical notes Element
G0800 Services provided by HH aide Element
G0804 Aides are members of interdisciplinary team Element
G0946 Administrator appointed by governing body Element
G0948 Responsible for all day-to-day operations Element
G0952 Ensure that HHA employs qualified personnel Element
G0960 Make patient and personnel assignments, Element
G0962 Coordinate patient care Element
G0966 Assure patient needs are continually assessed Element
G0968 Assure implementation of plan of care Element
G0974 Direct support and administrative control Element
G0978 Must have a written agreement Element
G0980 Primary HHA is responsible for patient care Element
G0984 In accordance with current clinical practice Element
▼ 157589 Viaquest Home Health Of Indiana, Llc 3409 N Briarwood Lane Muncie IN 5 (Chicago) 08/13/2019 4J7011 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0640 Quality assessment/performance improvement Condition
G0680 Infection prevention and control Condition
G0572 Plan of care Standard
G0682 Infection Prevention Standard
G0684 Infection control Standard
G0798 Home health aide assignments and duties Standard
G0942 Governing body Standard
G0412 Written notice of patient's rights Element
G0414 HHA administrator contact information Element
G0530 Strengths, goals, and care preferences Element
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0614 Visit schedule Element
G0616 Patient medication schedule/instructions Element
G0622 Name/contact information of clinical manager Element
G0984 In accordance with current clinical practice Element
▼ 157591 Maxim Healthcare Services Inc 3000 East Coliseum Blvd Ste 300 Fort Wayne IN 5 (Chicago) 12/10/2018 6ID111 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
G0578 Conformance with physician orders Standard
G0684 Infection control Standard
G0798 Home health aide assignments and duties Standard
G0574 Plan of care must include the following Element
G0602 Communication with all physicians Element
▼ 157592 Lmr Indiana Home Health Inc 1563 E 85th Ave Merrillville IN 5 (Chicago) 05/22/2025 65B50-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
G0572 Plan of care Standard
G0642 Program scope Standard
G1024 Authentication Standard
G0514 RN performs assessment Element
G0528 Health, psychosocial, functional, cognition 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
G0584 Verbal orders Element
G0590 Promptly alert relevant physician of changes Element
G0602 Communication with all physicians Element
G0606 Integrate all services Element