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
▼ 15K079 Attentive Home Healthcare Llc 5226 S East Street Suite A9 Indianapolis IN 5 (Chicago) 11/30/2018 KY8B11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0800 Services provided by HH aide Element
▼ 15K080 Lifestyles Homecare Llc 107 Federal Drive Chesterfield IN 5 (Chicago) 06/09/2025 6661C-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
G0436 Receive all services in plan of care Element
G0574 Plan of care must include the following Element
G0580 Only as ordered by a physician Element
G0588 Reviewed, revised by physician every 60 days Element
▼ 15K080 Lifestyles Homecare Llc 107 Federal Drive Chesterfield IN 5 (Chicago) 07/14/2022 4EADC-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0682 Infection Prevention Standard
G0768 Competency evaluation Standard
G1030 Retrieval of records Standard
G0434 Participate in care Element
G0470 Document efforts to resolve problems Element
G0528 Health, psychosocial, functional, cognition Element
G0574 Plan of care must include the following Element
G0590 Promptly alert relevant physician of changes Element
G0772 Documentation of competency evaluation Element
G0800 Services provided by HH aide Element
G0946 Administrator appointed by governing body Element
G1012 Required items in clinical record Element
▼ 15K081 Senior Support Services Inc 703 W Chapel Pike Marion IN 5 (Chicago) 07/27/2022 4F0B1-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0570 Care planning, coordination, quality of care Condition
G0640 Quality assessment/performance improvement Condition
G0750 Home health aide services Condition
G0578 Conformance with physician orders Standard
G0642 Program scope Standard
G0658 Performance improvement projects Standard
G0660 Executive responsibilities for QAPI Standard
G0682 Infection Prevention Standard
G0687 COVID-19 Vaccination of Home Health Agency staff Standard
G0768 Competency evaluation Standard
G0798 Home health aide assignments and duties Standard
G0942 Governing body Standard
G1030 Retrieval of records Standard
G0446 Contact info Federal/State-funded entities Element
G0454 HHA can no longer meet the patient's needs 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
G0622 Name/contact information of clinical manager 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
G0818 HH aide supervision elements Element
▼ 15K081 Senior Support Services Inc 703 W Chapel Pike Marion IN 5 (Chicago) 07/22/2019 K1BR11 Complaint, Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0682 Infection Prevention Standard
G0710 Provide services in the plan of care Element
G1014 Interventions and patient response Element
▼ 15K082 Community Hc, Llc 7779 E Ridge Road Ste B Hobart IN 5 (Chicago) 03/02/2021 L1F411 Complaint, Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0510 Comprehensive Assessment of Patients 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
G0940 Organization and administration of services Condition
G0372 Encoding and transmitting OASIS Standard
G0374 Accuracy of encoded OASIS data Standard
G0544 Update of the comprehensive assessment Standard
G0564 Discharge or Transfer Summary Content Standard
G0572 Plan of care 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
G0942 Governing body Standard
G0438 Have a confidential clinical record Element
G0478 Investigate complaints made by patient Element
G0528 Health, psychosocial, functional, cognition Element
G0532 Continuing need for home care Element
G0534 Patient's needs 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
G0592 Revised plan of care Element
G0610 Patients receive education and training Element
G0614 Visit schedule Element
G0616 Patient medication schedule/instructions Element
G0618 Treatments and therapy services Element
G0622 Name/contact information of clinical manager Element
G0706 Interdisciplinary assessment of the patient Element
G0710 Provide services in the plan of care Element
G0714 Patient and caregiver education Element
G0718 Communication with physicians Element
G0720 Participate in the HHA's QAPI program; Element
G0722 Participate in HHA-sponsored in-service Element
G0726 Nursing services supervised by RN Element
G0800 Services provided by HH aide Element
G0948 Responsible for all day-to-day operations Element
G0966 Assure patient needs are continually assessed Element
G0968 Assure implementation of plan of care Element
▼ 15K082 Community Hc, Llc 7779 E Ridge Road Ste B Hobart IN 5 (Chicago) 02/08/2018 E1W311 Complaint, Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0406 Patient rights Condition
G0510 Comprehensive Assessment of Patients 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
G0940 Organization and administration of services Condition
G1008 Clinical records Condition
G0372 Encoding and transmitting OASIS Standard
G0512 Standard: Initial assessment visit. Standard
G0572 Plan of care Standard
G0642 Program scope Standard
G0644 Program data Standard
G0660 Executive responsibilities for QAPI Standard
G0682 Infection Prevention Standard
G0686 Infection control education Standard
G0768 Competency evaluation Standard
G0798 Home health aide assignments and duties Standard
G0942 Governing body Standard
G0988 Institutional planning Standard
G1024 Authentication Standard
G0438 Have a confidential clinical record Element
G0464 Advise the patient of discharge for cause Element
G0480 Treatment or care Element
G0514 RN performs assessment Element
G0528 Health, psychosocial, functional, cognition Element
G0536 A review of all current medications Element
G0546 Last 5 days of every 60 days unless: 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
G0592 Revised plan of care Element
G0606 Integrate all services Element
G0608 Coordinate care delivery Element
G0650 Incidence, prevalence, severity of problems 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
G0720 Participate in the HHA's QAPI program; Element
G0726 Nursing services supervised by RN Element
G0772 Documentation of competency evaluation Element
G0800 Services provided by HH aide Element
G0808 Onsite supervisory visit every 14 days Element
G0948 Responsible for all day-to-day operations Element
G0952 Ensure that HHA employs qualified personnel Element
G0962 Coordinate patient care Element
G0984 In accordance with current clinical practice Element
G1012 Required items in clinical record Element
G1016 Goals in the patient's plans of care Element
G1022 Discharge and transfer summaries Element
▼ 15K083 Purpose Home Health Llc 5455 Harrison Park Lane Ste B Indianapolis IN 5 (Chicago) 09/10/2025 1D2328-H2 Complaint
Deficiency Tag Deficiency Description Tag Type
G0782 Eligible training/competency evaluation orgs. Standard
▼ 15K083 Purpose Home Health Llc 5455 Harrison Park Lane Ste B Indianapolis IN 5 (Chicago) 08/04/2025 1D2328-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0750 Home health aide services Condition
G0682 Infection Prevention Standard
G0798 Home health aide assignments and duties Standard
G0528 Health, psychosocial, functional, cognition Element
G0574 Plan of care must include the following Element
G0754 A qualified HH aide successfully completed: Element
G0762 Minimum hours of training Element
G0800 Services provided by HH aide Element
G0812 If area of concern is noted Element
G0948 Responsible for all day-to-day operations Element
▼ 15K083 Purpose Home Health Llc 5455 Harrison Park Lane Ste B Indianapolis IN 5 (Chicago) 10/10/2024 645B8-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0608 Coordinate care delivery Element