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
▼ 15K161 1st Priority Healthcare Inc 2804 E 55th Place Suite R Indianapolis IN 5 (Chicago) 04/19/2024 62995-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0682 Infection Prevention Standard
G1052 Administrator Standard
G0766 HHA maintains documentation of training Element
G0802 Duties of a HH aide Element
G0952 Ensure that HHA employs qualified personnel Element
▼ 15K161 1st Priority Healthcare Inc 2804 E 55th Place Suite R Indianapolis IN 5 (Chicago) 08/31/2023 60B91-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
G0528 Health, psychosocial, functional, cognition Element
G0536 A review of all current medications Element
G0588 Reviewed, revised by physician every 60 days Element
G0804 Aides are members of interdisciplinary team Element
▼ 15K161 1st Priority Healthcare Inc 2804 E 55th Place Suite R Indianapolis IN 5 (Chicago) 11/09/2020 C7ID11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0654 Track adverse patient events Standard
G1024 Authentication Standard
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
G0804 Aides are members of interdisciplinary team Element
G0808 Onsite supervisory visit every 14 days Element
G0978 Must have a written agreement Element
G1012 Required items in clinical record Element
G1022 Discharge and transfer summaries Element
▼ 15K162 Helping Angels, Inc 1125 Broadway Street Suite B Anderson IN 5 (Chicago) 02/23/2021 ICZT11 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
G1008 Clinical records Condition
G0642 Program scope Standard
G0682 Infection Prevention Standard
G0684 Infection control Standard
G0768 Competency evaluation Standard
G0798 Home health aide assignments and duties Standard
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
G0538 Primary caregiver(s), if any Element
G0574 Plan of care must include the following Element
G0580 Only as ordered by a physician Element
G0584 Verbal orders Element
G0590 Promptly alert relevant physician of changes Element
G0592 Revised plan of care Element
G0608 Coordinate care delivery Element
G0614 Visit schedule Element
G0618 Treatments and therapy services Element
G0622 Name/contact information of clinical manager Element
G0656 Improvements are sustained Element
G0706 Interdisciplinary assessment of the patient Element
G0800 Services provided by HH aide Element
G0978 Must have a written agreement Element
G0980 Primary HHA is responsible for patient care Element
▼ 15K162 Helping Angels, Inc 1125 Broadway Street Suite B Anderson IN 5 (Chicago) 01/11/2018 G1YO11 Initial Certification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0102 NOTICE OF RIGHTS Standard
G0121 COMPLIANCE W/ ACCEPTED PROFESSIONAL STD Standard
G0225 ASSIGNMENT & DUTIES OF HOME HEALTH AIDE Standard
G0236 CLINICAL RECORDS Standard
▼ 15K163 Elite Home Healthcare, Llc 1009 14th Street Bedford IN 5 (Chicago) 03/10/2026 1E3530-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0768 Competency evaluation Standard
▼ 15K163 Elite Home Healthcare, Llc 1009 14th Street Bedford IN 5 (Chicago) 01/26/2024 61E50-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0940 Organization and administration of services Condition
G0958 Clinical manager Standard
G0574 Plan of care must include the following Element
▼ 15K163 Elite Home Healthcare, Llc 1009 14th Street Bedford IN 5 (Chicago) 02/08/2018 HEZH11 Initial Certification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G1012 Required items in clinical record Element
▼ 15K164 Apple Tree Home Health Care Services, Llc 5257 N Tacoma Dr Suite 4 Indianapolis IN 5 (Chicago) 01/27/2025 64DD2-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
E0001 Establishment of the Emergency Program (EP) Condition
G0570 Care planning, coordination, quality of care Condition
G0640 Quality assessment/performance improvement Condition
G0572 Plan of care Standard
G0612 Written instructions to patient include: Standard
G0682 Infection Prevention Standard
G0942 Governing body Standard
G0412 Written notice of patient's rights 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
G0614 Visit schedule Element
G0616 Patient medication schedule/instructions Element
G0808 Onsite supervisory visit every 14 days Element
▼ 15K164 Apple Tree Home Health Care Services, Llc 5257 N Tacoma Dr Suite 4 Indianapolis IN 5 (Chicago) 09/25/2023 610B5-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0006 Plan Based on All Hazards Risk Assessment Standard
G0682 Infection Prevention Standard