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
▼ 15K125 Preference Health Services Inc 3022 45th Street Highland IN 5 (Chicago) 08/22/2025 65B61-H1 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
G0644 Program data Standard
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0948 Responsible for all day-to-day operations Element
▼ 15K125 Preference Health Services Inc 3022 45th Street Highland IN 5 (Chicago) 09/29/2022 4F766-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0682 Infection Prevention Standard
G0440 Payment from federally funded programs Element
G0528 Health, psychosocial, functional, cognition Element
G0530 Strengths, goals, and care preferences Element
G0534 Patient's needs Element
G0574 Plan of care must include the following Element
▼ 15K125 Preference Health Services Inc 3022 45th Street Highland IN 5 (Chicago) 09/28/2018 KZXZ11 Complaint, Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0370 Reporting OASIS information Condition
G0570 Care planning, coordination, quality of care Condition
G0750 Home health aide services Condition
G1008 Clinical records Condition
G0372 Encoding and transmitting OASIS Standard
G0572 Plan of care Standard
G0644 Program data Standard
G0682 Infection Prevention Standard
G0768 Competency evaluation Standard
G0798 Home health aide assignments and duties Standard
G1024 Authentication Standard
G0434 Participate in care Element
G0442 Written notice for non-covered care Element
G0444 State toll free HH telephone hotline Element
G0548 Within 48 hours of the patient's return Element
G0550 At discharge Element
G0580 Only as ordered by a physician Element
G0588 Reviewed, revised by physician every 60 days Element
G0590 Promptly alert relevant physician of changes Element
G0598 Discharge plans communication Element
G0606 Integrate all services Element
G0614 Visit schedule Element
G0710 Provide services in the plan of care Element
G0800 Services provided by HH aide Element
G0804 Aides are members of interdisciplinary team Element
G0808 Onsite supervisory visit every 14 days Element
G0818 HH aide supervision elements Element
G0948 Responsible for all day-to-day operations Element
G0962 Coordinate patient care Element
G1012 Required items in clinical record Element
G1022 Discharge and transfer summaries Element
▼ 15K130 Heal At Home Llc 1335 Sadlier Circle East Drive Indianapolis IN 5 (Chicago) 10/30/2024 647A3-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0768 Competency evaluation Standard
G0958 Clinical manager Standard
G0978 Must have a written agreement Element
▼ 15K130 Heal At Home Llc 1335 Sadlier Circle East Drive Indianapolis IN 5 (Chicago) 08/14/2024 63DC0-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0406 Condition of Participation: Patient rights. Condition
G0560 Discharge Planning Condition
G0750 Home health aide services Condition
G0940 Organization and administration of services Condition
G0452 Transfer and discharge Standard
G0562 Discharge Planning Standard
G0682 Infection Prevention Standard
G0798 Home health aide assignments and duties Standard
G0942 Governing body Standard
G0434 Participate in care Element
G0574 Plan of care must include the following Element
G0584 Verbal orders Element
G0598 Discharge plans communication Element
G0778 Documentation of inservice training Element
G0800 Services provided by HH aide Element
G0948 Responsible for all day-to-day operations Element
▼ 15K130 Heal At Home Llc 1335 Sadlier Circle East Drive Indianapolis IN 5 (Chicago) 06/10/2024 63484-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
G0612 Written instructions to patient include: Standard
G0682 Infection Prevention Standard
G0536 A review of all current medications Element
G0590 Promptly alert relevant physician of changes Element
▼ 15K130 Heal At Home Llc 1335 Sadlier Circle East Drive Indianapolis IN 5 (Chicago) 01/03/2024 61232-H2 Complaint
Deficiency Tag Deficiency Description Tag Type
G0644 Program data Standard
G0658 Performance improvement projects Standard
G0660 Executive responsibilities for QAPI Standard
▼ 15K130 Heal At Home Llc 1335 Sadlier Circle East Drive Indianapolis IN 5 (Chicago) 11/09/2023 61232-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0640 Quality assessment/performance improvement Condition
G0768 Competency evaluation Standard
G0530 Strengths, goals, and care preferences Element
G0584 Verbal orders Element
G0754 A qualified HH aide successfully completed: Element
G0804 Aides are members of interdisciplinary team Element
▼ 15K130 Heal At Home Llc 1335 Sadlier Circle East Drive Indianapolis IN 5 (Chicago) 07/21/2021 NNPN11 Complaint, Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
▼ 15K130 Heal At Home Llc 1335 Sadlier Circle East Drive Indianapolis IN 5 (Chicago) 12/18/2018 8Z2J11 Complaint, Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0682 Infection Prevention Standard
G0798 Home health aide assignments and duties Standard
G0436 Receive all services in plan of care Element
G0464 Advise the patient of discharge for cause Element
G0574 Plan of care must include the following Element
G0590 Promptly alert relevant physician of changes Element
G0608 Coordinate care delivery Element
G0706 Interdisciplinary assessment of the patient Element
G0718 Communication with physicians Element
G0800 Services provided by HH aide Element