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
▼ 15K060 Bethany Cares Inc D/B/A 3637 S Sr 3 New Castle IN 5 (Chicago) 02/09/2023 5EC29-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
E0006 Plan Based on All Hazards Risk Assessment Standard
G0682 Infection Prevention Standard
G0798 Home health aide assignments and duties Standard
G0460 Patient refuses services Element
G0590 Promptly alert relevant physician of changes Element
G0608 Coordinate care delivery Element
G0804 Aides are members of interdisciplinary team Element
▼ 15K060 Bethany Cares Inc D/B/A 3637 S Sr 3 New Castle IN 5 (Chicago) 07/30/2021 6L1M11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0682 Infection Prevention Standard
G0684 Infection control Standard
G0436 Receive all services in plan of care Element
G0438 Have a confidential clinical record Element
G0528 Health, psychosocial, functional, cognition Element
G0530 Strengths, goals, and care preferences Element
G0538 Primary caregiver(s), if any Element
G0574 Plan of care must include the following Element
▼ 15K060 Bethany Cares Inc D/B/A 3637 S Sr 3 New Castle IN 5 (Chicago) 01/14/2020 RPJ611 Complaint, Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0406 Patient rights Condition
G0570 Care planning, coordination, quality of care Condition
G0640 Quality assessment/performance improvement Condition
G0750 Home health aide services Condition
G0642 Program scope Standard
G0644 Program data Standard
G0682 Infection Prevention Standard
G0768 Competency evaluation Standard
G0942 Governing body Standard
G1024 Authentication Standard
G0466 Make efforts to resolve the problem(s) 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
G0656 Improvements are sustained Element
G0706 Interdisciplinary assessment of the patient Element
G0710 Provide services in the plan of care Element
G0800 Services provided by HH aide 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
▼ 15K060 Bethany Cares Inc D/B/A 3637 S Sr 3 New Castle IN 5 (Chicago) 02/12/2018 BL8B11 Complaint, Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0374 Accuracy of encoded OASIS data Standard
G0476 Investigation of complaints Standard
G0642 Program scope Standard
G0654 Track adverse patient events Standard
G0660 Executive responsibilities for QAPI Standard
G0684 Infection control Standard
G0454 HHA can no longer meet the patient's needs Element
G0484 Document complaint and resolution Element
G0514 RN performs assessment Element
G0520 5 calendar days after start of care Element
G0550 At discharge 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
G0608 Coordinate care delivery 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
G0962 Coordinate patient care Element
G0964 Coordinate referrals; Element
G0966 Assure patient needs are continually assessed Element
G0984 In accordance with current clinical practice Element
G1022 Discharge and transfer summaries Element
▼ 15K062 Pediatric Plus Home Healthcare Services Llc 925 Main Street Jeffersonville IN 5 (Chicago) 08/14/2025 1D3780-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0007 EP Program Patient Population Standard
E0013 Development of EP Policies and Procedures Standard
E0023 Policies/Procedures for Medical Documentation Standard
E0037 EP Training Program Standard
E0039 EP Testing Requirements Standard
G0774 12 hours inservice every 12 months Standard
G0514 RN performs assessment Element
G0948 Responsible for all day-to-day operations Element
G1012 Required items in clinical record Element
▼ 15K062 Pediatric Plus Home Healthcare Services Llc 925 Main Street Jeffersonville IN 5 (Chicago) 12/14/2022 5E6D3-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0687 COVID-19 Vaccination of Home Health Agency staff Standard
G0574 Plan of care must include the following Element
▼ 15K062 Pediatric Plus Home Healthcare Services Llc 925 Main Street Jeffersonville IN 5 (Chicago) 01/27/2020 6YZX11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0570 Care planning, coordination, quality of care Condition
G0572 Plan of care Standard
G0644 Program data Standard
G0682 Infection Prevention Standard
G0982 Skilled services furnished Standard
G1024 Authentication Standard
G0486 Protect patient during investigation Element
G0514 RN performs assessment Element
G0520 5 calendar days after start of care 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
G0580 Only as ordered by a physician Element
G0608 Coordinate care delivery Element
G0614 Visit schedule Element
G0718 Communication with physicians Element
G0726 Nursing services supervised by RN Element
▼ 15K065 Help At Home Llc 1015 Professional Blvd Suite B Evansville IN 5 (Chicago) 06/23/2026 2342BA-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G1024 Authentication Standard
▼ 15K065 Help At Home Llc 1015 Professional Blvd Suite B Evansville IN 5 (Chicago) 04/28/2025 65E5B-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
G0982 Skilled services furnished Standard
G0436 Receive all services in plan of care Element
G0974 Direct support and administrative control Element
G1022 Discharge and transfer summaries Element
▼ 15K065 Help At Home Llc 1015 Professional Blvd Suite B Evansville IN 5 (Chicago) 10/07/2022 4F77E-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0710 Provide services in the plan of care Element