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
▼ 15K151 Touch Of Love Home Health Care Inc 6919 E 10th Street, Suite B-1 Indianapolis IN 5 (Chicago) 09/27/2023 61181-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
G0948 Responsible for all day-to-day operations Element
▼ 15K151 Touch Of Love Home Health Care Inc 6919 E 10th Street, Suite B-1 Indianapolis IN 5 (Chicago) 09/30/2020 BZ8I11 Complaint, Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0544 Update of the comprehensive assessment Standard
G0682 Infection Prevention Standard
G0684 Infection control Standard
G0686 Infection control education Standard
G0798 Home health aide assignments and duties Standard
G0454 HHA can no longer meet the patient's needs Element
G0528 Health, psychosocial, functional, cognition Element
G0530 Strengths, goals, and care preferences Element
G0534 Patient's needs Element
G0536 A review of all current medications Element
G0550 At discharge Element
G0574 Plan of care must include the following Element
G0576 All orders recorded in plan of care Element
G0592 Revised plan of care Element
G0608 Coordinate care delivery Element
G0706 Interdisciplinary assessment of the patient Element
G0800 Services provided by HH aide Element
G0954 Ensures qualified pre-designated person Element
G0978 Must have a written agreement Element
G0980 Primary HHA is responsible for patient care Element
▼ 15K152 Together Homecare Of Fort Wayne Llc 5614 Industrial Road Fort Wayne IN 5 (Chicago) 03/11/2025 65975-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
▼ 15K152 Together Homecare Of Fort Wayne Llc 5614 Industrial Road Fort Wayne IN 5 (Chicago) 06/05/2023 5FE8F-H1 Complaint
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
G0572 Plan of care Standard
G0682 Infection Prevention Standard
G1028 Protection of records Standard
G0430 Be free from abuse 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
G0590 Promptly alert relevant physician of changes Element
G0706 Interdisciplinary assessment of the patient Element
G0710 Provide services in the plan of care Element
G0726 Nursing services supervised by RN Element
▼ 15K152 Together Homecare Of Fort Wayne Llc 5614 Industrial Road Fort Wayne IN 5 (Chicago) 05/23/2022 4EA1F-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
G0544 Update of the comprehensive assessment Standard
G0600 Coordination of Care Standard
G0798 Home health aide assignments and duties Standard
G1024 Authentication Standard
G0952 Ensure that HHA employs qualified personnel Element
▼ 15K152 Together Homecare Of Fort Wayne Llc 5614 Industrial Road Fort Wayne IN 5 (Chicago) 06/25/2019 PNED11 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
G0940 Organization and administration of services Condition
G0544 Update of the comprehensive assessment Standard
G0572 Plan of care Standard
G0682 Infection Prevention Standard
G0478 Investigate complaints made by patient Element
G0484 Document complaint and resolution Element
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0590 Promptly alert relevant physician of changes Element
G0606 Integrate all services Element
G0706 Interdisciplinary assessment of the patient Element
G0802 Duties of a HH aide Element
G0960 Make patient and personnel assignments, Element
G0966 Assure patient needs are continually assessed Element
G0968 Assure implementation of plan of care Element
G0978 Must have a written agreement Element
G0980 Primary HHA is responsible for patient care Element
▼ 15K153 Am - Pm Home Health Services Llc 3906 W 86th Street Indianapolis IN 5 (Chicago) 03/13/2026 1F3180-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0514 RN performs assessment Element
G0574 Plan of care must include the following Element
▼ 15K153 Am - Pm Home Health Services Llc 3906 W 86th Street Indianapolis IN 5 (Chicago) 09/08/2023 5F93D-H4 Recertification
Deficiency Tag Deficiency Description Tag Type
G0544 Update of the comprehensive assessment Standard
G0768 Competency evaluation Standard
G0798 Home health aide assignments and duties Standard
▼ 15K153 Am - Pm Home Health Services Llc 3906 W 86th Street Indianapolis IN 5 (Chicago) 07/20/2023 5F93D-H3 Recertification
Deficiency Tag Deficiency Description Tag Type
G0528 Health, psychosocial, functional, cognition Element
G0602 Communication with all physicians Element
G0604 Integrate all orders Element
G0800 Services provided by HH aide Element
G0818 HH aide supervision elements Element
▼ 15K153 Am - Pm Home Health Services Llc 3906 W 86th Street Indianapolis IN 5 (Chicago) 04/25/2023 5F93D-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
G0680 Infection prevention and control Condition
G0682 Infection Prevention Standard
G0684 Infection control Standard
G0687 COVID-19 Vaccination of Home Health Agency staff Standard
G0942 Governing body Standard
G0574 Plan of care must include the following Element
G0590 Promptly alert relevant physician of changes Element
G0616 Patient medication schedule/instructions Element
G0948 Responsible for all day-to-day operations Element