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
▼ 157695 First Horizon Home Health Care Llc 745 Beachway Drive Indianapolis IN 5 (Chicago) 10/22/2024 6475D-H1 Complaint
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
G0514 RN performs assessment Element
G0574 Plan of care must include the following Element
G0580 Only as ordered by a physician Element
G0608 Coordinate care delivery Element
▼ 157695 First Horizon Home Health Care Llc 745 Beachway Drive Indianapolis IN 5 (Chicago) 10/22/2024 648A6-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0940 Organization and administration of services Condition
▼ 157697 Foster Home Care Services Inc 7550 Hohman Avenue, Suite 1000 Munster IN 5 (Chicago) 01/29/2021 NJIB11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0644 Program data Standard
G0658 Performance improvement projects Standard
G0444 State toll free HH telephone hotline Element
G0948 Responsible for all day-to-day operations Element
▼ 157698 Bayada Home Health Care Inc 6351 Constitution Drive Fort Wayne IN 5 (Chicago) 10/05/2022 4F7EE-H1 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
G0982 Skilled services furnished Standard
G0414 HHA administrator contact information Element
G0530 Strengths, goals, and care preferences Element
G0574 Plan of care must include the following Element
G0856 Officer, a director, agent, managing employee Element
G0946 Administrator appointed by governing body Element
G0954 Ensures qualified pre-designated person Element
▼ 157699 United Home Health Care Llc 4535 N Wheeling Ave Muncie IN 5 (Chicago) 04/28/2026 22CA89-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
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
▼ 157700 Indiana Masonic Home, Inc 690 S State Street Franklin IN 5 (Chicago) 07/26/2024 6356D-H2 Complaint
Deficiency Tag Deficiency Description Tag Type
G0536 A review of all current medications Element
▼ 157700 Indiana Masonic Home, Inc 690 S State Street Franklin IN 5 (Chicago) 06/17/2024 6356D-H1 Complaint
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
G0680 Infection prevention and control Condition
G0572 Plan of care Standard
G0612 Written instructions to patient include: Standard
G0654 Track adverse patient events Standard
G0658 Performance improvement projects Standard
G0682 Infection Prevention Standard
G0580 Only as ordered by a physician Element
G0590 Promptly alert relevant physician of changes Element
G0716 Preparing clinical notes Element
G0984 In accordance with current clinical practice Element
▼ 157700 Indiana Masonic Home, Inc 690 S State Street Franklin IN 5 (Chicago) 05/31/2018 2BHX11 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
G0702 Services by skilled professionals Standard
G0574 Plan of care must include the following Element
G0710 Provide services in the plan of care Element
▼ 157703 E Medical Group Of Indiana No. 2, Llc 5401 Vogel Road Ste 110 Evansville IN 5 (Chicago) 03/18/2026 1F4E7B-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0602 Communication with all physicians Element
G0604 Integrate all orders Element
G0608 Coordinate care delivery Element
▼ 157704 Greatland Healthcare Of Indiana Inc 9616 Indianapolis Blvd 2nd Floor Ste D Highland IN 5 (Chicago) 06/13/2025 6650C-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
G0940 Organization and administration of services Condition
G0572 Plan of care Standard
G0612 Written instructions to patient include: Standard
G0528 Health, psychosocial, functional, cognition 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
G0584 Verbal orders Element
G0614 Visit schedule Element
G0616 Patient medication schedule/instructions Element
G0622 Name/contact information of clinical manager Element
G0710 Provide services in the plan of care Element
G0716 Preparing clinical notes Element
G1018 Contact information for the patient Element
G1022 Discharge and transfer summaries Element