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
▼ 157598 Caretenders Visiting Services Of Kentuckiana Llc 1140 W Jefferson Street Ste B Franklin IN 5 (Chicago) 05/01/2019 UJOQ11 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
G0510 Comprehensive Assessment of Patients Condition
G0570 Care planning, coordination, quality of care Condition
G0940 Organization and administration of services Condition
G0526 Content of the comprehensive assessment Standard
G0572 Plan of care Standard
G0578 Conformance with physician orders Standard
G0644 Program data Standard
G0660 Executive responsibilities for QAPI Standard
G0514 RN performs assessment Element
G0528 Health, psychosocial, functional, cognition Element
G0536 A review of all current medications Element
G0548 Within 48 hours of the patient's return Element
G0574 Plan of care must include the following Element
G0584 Verbal orders Element
G0590 Promptly alert relevant physician of changes Element
G0656 Improvements are sustained Element
G0706 Interdisciplinary assessment of the patient Element
G0716 Preparing clinical notes Element
G0718 Communication with physicians Element
▼ 157599 Hearts With Integrity Llc 603 E North Street Hartford City IN 5 (Chicago) 05/16/2024 61F9D-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G1030 Retrieval of records Standard
G0536 A review of all current medications Element
G0580 Only as ordered by a physician Element
▼ 157599 Hearts With Integrity Llc 603 E North Street Hartford City IN 5 (Chicago) 07/25/2018 KOS411 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
G0574 Plan of care must include the following Element
G0602 Communication with all physicians Element
▼ 157601 Cardinal Home Health Services Inc 7863 Broadway Ste 217 Merrillville IN 5 (Chicago) 02/26/2025 65635-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
E0009 Local, State, Tribal Collaboration Process Standard
E0030 Names and Contact Information Standard
E0036 EP Training and Testing Standard
G0372 Encoding and transmitting OASIS Standard
G0544 Update of the comprehensive assessment Standard
G0572 Plan of care Standard
G0644 Program data Standard
G0646 Program activities Standard
G0774 12 hours inservice every 12 months Standard
G1024 Authentication Standard
G0434 Participate in care Element
G0514 RN performs assessment Element
G0520 5 calendar days after start of care Element
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
G0606 Integrate all services Element
G0800 Services provided by HH aide Element
G0808 Onsite supervisory visit every 14 days Element
G0818 HH aide supervision elements Element
G1022 Discharge and transfer summaries Element
▼ 157601 Cardinal Home Health Services Inc 7863 Broadway Ste 217 Merrillville IN 5 (Chicago) 04/19/2022 3853A-H2 Recertification
Deficiency Tag Deficiency Description Tag Type
E0017 HHA Comprehensive Assessment in Disaster Standard
G0572 Plan of care Standard
G0682 Infection Prevention Standard
G0798 Home health aide assignments and duties Standard
G1024 Authentication Standard
G0458 Outcomes/goals have been achieved Element
G0528 Health, psychosocial, functional, cognition 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
G0592 Revised plan of care Element
G0606 Integrate all services Element
G0614 Visit schedule Element
G0616 Patient medication schedule/instructions Element
G0618 Treatments and therapy services Element
G0708 Development and evaluation of plan of care Element
G0710 Provide services in the plan of care Element
G0716 Preparing clinical notes Element
G0804 Aides are members of interdisciplinary team Element
G1012 Required items in clinical record Element
▼ 157601 Cardinal Home Health Services Inc 7863 Broadway Ste 217 Merrillville IN 5 (Chicago) 02/21/2022 3853A-H1 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
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
G0750 Home health aide services Condition
E0009 Local, State, Tribal Collaboration Process Standard
E0021 HHA- Procedures for Follow up Staff/Pts. Standard
E0023 Policies/Procedures for Medical Documentation Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0030 Names and Contact Information Standard
E0033 Methods for Sharing Information Standard
E0039 EP Testing Requirements Standard
G0374 Accuracy of encoded OASIS data Standard
G0544 Update of the comprehensive assessment Standard
G0654 Track adverse patient events Standard
G0658 Performance improvement projects Standard
G0686 Infection control education Standard
G0687 COVID-19 Vaccination of Home Health Agency staff Standard
G0724 Supervise skilled professional assistants Standard
G0958 Clinical manager Standard
G0414 HHA administrator contact information Element
G0434 Participate in care Element
G0460 Patient refuses services Element
G0514 RN performs assessment Element
G0584 Verbal orders Element
G0588 Reviewed, revised by physician every 60 days Element
G0590 Promptly alert relevant physician of changes Element
G0598 Discharge plans communication Element
G0622 Name/contact information of clinical manager Element
G0650 Incidence, prevalence, severity of problems Element
G0652 Activities lead to an immediate correction Element
G0656 Improvements are sustained Element
G0714 Patient and caregiver education Element
G0718 Communication with physicians Element
G0720 Participate in the HHA's QAPI program; Element
G0800 Services provided by HH aide Element
G0818 HH aide supervision elements Element
G0948 Responsible for all day-to-day operations Element
G0960 Make patient and personnel assignments, Element
G1022 Discharge and transfer summaries Element
▼ 157605 First Choice Home Health Services Inc 6 Morgan Blvd Ste 101 Valparaiso IN 5 (Chicago) 12/11/2020 ZMLY11 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
E0001 Establishment of the Emergency Program (EP) Condition
G0370 Reporting OASIS information Condition
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
G0940 Organization and administration of services Condition
G1008 Clinical records Condition
G0374 Accuracy of encoded OASIS data Standard
G0572 Plan of care Standard
G0660 Executive responsibilities for QAPI Standard
G0682 Infection Prevention Standard
G0684 Infection control Standard
G0686 Infection control education Standard
G0768 Competency evaluation Standard
G0774 12 hours inservice every 12 months Standard
G0798 Home health aide assignments and duties Standard
G1024 Authentication Standard
G0436 Receive all services in plan of care Element
G0442 Written notice for non-covered care Element
G0444 State toll free HH telephone hotline Element
G0460 Patient refuses services Element
G0480 Treatment or care Element
G0484 Document complaint and resolution Element
G0528 Health, psychosocial, functional, cognition 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
G0580 Only as ordered by a physician Element
G0584 Verbal orders Element
G0588 Reviewed, revised by physician every 60 days Element
G0590 Promptly alert relevant physician of changes Element
G0606 Integrate all services Element
G0614 Visit schedule Element
G0616 Patient medication schedule/instructions Element
G0720 Participate in the HHA's QAPI program; Element
G0722 Participate in HHA-sponsored in-service Element
G0808 Onsite supervisory visit every 14 days Element
G0818 HH aide supervision elements Element
G0948 Responsible for all day-to-day operations Element
G0950 Ensure clinical manager is available Element
G0954 Ensures qualified pre-designated person Element
G0956 Available during all operating hours Element
G1014 Interventions and patient response Element
G1022 Discharge and transfer summaries Element
▼ 157606 Loving Care Agency Inc 2629 Waterfront Pkwy E Dr Ste 150 Indianapolis IN 5 (Chicago) 01/24/2024 61F26-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0436 Receive all services in plan of care Element
G0580 Only as ordered by a physician Element
G1012 Required items in clinical record Element
▼ 157606 Loving Care Agency Inc 2629 Waterfront Pkwy E Dr Ste 150 Indianapolis IN 5 (Chicago) 03/31/2021 N6RP11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0798 Home health aide assignments and duties Standard
G0942 Governing body Standard
G0574 Plan of care must include the following Element
▼ 157608 Hoosier Homecare Services Llc 614 East 53rd Street Anderson IN 5 (Chicago) 08/15/2024 63E04-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0714 Patient and caregiver education Element