S&C QCOR HHA 2567s
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HHAs 2567s
Selection Criteria ▸

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
▼ 15K091 Help At Home Inc 9025 Coldwater Rd Ste 400 Fort Wayne IN 5 (Chicago) 03/28/2019 G1SU11 Complaint, Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0682 Infection Prevention Standard
G0852 Information to the state survey agency Standard
▼ 15K093 Adaptive Nursing And Healthcare Services Llc 50 Washington Street Columbus IN 5 (Chicago) 05/19/2021 53ZV11 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
G0572 Plan of care Standard
G0682 Infection Prevention Standard
G1024 Authentication Standard
G0984 In accordance with current clinical practice Element
▼ 15K093 Adaptive Nursing And Healthcare Services Llc 50 Washington Street Columbus IN 5 (Chicago) 08/24/2020 S9V511 Complaint, Focused Infection Control, Other-Fed
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0406 Patient rights Condition
G0426 Rights of the patient Standard
G0682 Infection Prevention Standard
G1024 Authentication Standard
G0430 Be free from abuse Element
G0436 Receive all services in plan of care Element
G0448 Freedom from discrimination or reprisal Element
G0454 HHA can no longer meet the patient's needs Element
G0462 Before discharge for cause HHA must: Element
G0466 Make efforts to resolve the problem(s) Element
G0484 Document complaint and resolution Element
G0826 Ensure training/competency requirements Element
▼ 15K093 Adaptive Nursing And Healthcare Services Llc 50 Washington Street Columbus IN 5 (Chicago) 01/23/2020 TZ0611 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0682 Infection Prevention Standard
G0608 Coordinate care delivery Element
G0946 Administrator appointed by governing body Element
▼ 15K093 Adaptive Nursing And Healthcare Services Llc 50 Washington Street Columbus IN 5 (Chicago) 06/12/2018 2Z5G11 Complaint, Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0682 Infection Prevention Standard
G0454 HHA can no longer meet the patient's needs Element
G0514 RN performs assessment Element
G0536 A review of all current medications Element
G0804 Aides are members of interdisciplinary team Element
▼ 15K095 Tender Love Home Services Llc 7895 Broadway Ste L Merrillville IN 5 (Chicago) 02/14/2025 654B6-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0037 EP Training Program Standard
G0572 Plan of care Standard
G0682 Infection Prevention Standard
G0798 Home health aide assignments and duties 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
G0800 Services provided by HH aide Element
▼ 15K095 Tender Love Home Services Llc 7895 Broadway Ste L Merrillville IN 5 (Chicago) 02/15/2022 382AF-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
G0574 Plan of care must include the following Element
G0800 Services provided by HH aide Element
▼ 15K095 Tender Love Home Services Llc 7895 Broadway Ste L Merrillville IN 5 (Chicago) 06/27/2019 D32V11 Complaint, Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0800 Services provided by HH aide Element
▼ 15K097 4u Home Health Inc 8870 Zionsville Rd, Ste #300 Indianapolis IN 5 (Chicago) 05/22/2024 631F2-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
G0640 Quality assessment/performance improvement Condition
G0682 Infection Prevention Standard
G0988 Institutional planning Standard
G0528 Health, psychosocial, functional, cognition Element
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0584 Verbal orders Element
▼ 15K097 4u Home Health Inc 8870 Zionsville Rd, Ste #300 Indianapolis IN 5 (Chicago) 03/11/2019 SHDH11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0514 RN performs assessment Element
G0576 All orders recorded in plan of care Element
G0592 Revised plan of care Element
G0800 Services provided by HH aide Element