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
▼ 167024 Mary Greeley Medical Center 1114 Duff Avenue Ames IA 7 (Kansas City) 12/02/2020 5DIC11 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
E0019 Homebound HHA/Hospice Inform EP Officials Standard
E0036 EP Training and Testing Standard
E0037 EP Training Program Standard
G0548 Within 48 hours of the patient's return Element
G0574 Plan of care must include the following Element
G0580 Only as ordered by a physician Element
▼ 167024 Mary Greeley Medical Center 1114 Duff Avenue Ames IA 7 (Kansas City) 02/15/2018 RQIF11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0017 HHA Comprehensive Assessment in Disaster Standard
G0702 Services by skilled professionals Standard
G0548 Within 48 hours of the patient's return Element
G0574 Plan of care must include the following Element
G0718 Communication with physicians Element
▼ 167026 Des Moines County Health Department 505 Curran St Burlington IA 7 (Kansas City) 01/22/2026 1E11E2-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
G0580 Only as ordered by a physician Element
G0818 HH aide supervision elements Element
▼ 167026 Des Moines County Health Department 505 Curran St Burlington IA 7 (Kansas City) 01/11/2023 5EB2E-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0548 Within 48 hours of the patient's return 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
G1014 Interventions and patient response Element
▼ 167026 Des Moines County Health Department 505 Curran St Burlington IA 7 (Kansas City) 01/15/2020 FNHH11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0017 HHA Comprehensive Assessment in Disaster Standard
G0572 Plan of care Standard
G1024 Authentication Standard
G0536 A review of all current medications Element
G0550 At discharge Element
G0574 Plan of care must include the following Element
G0710 Provide services in the plan of care Element
G0718 Communication with physicians Element
G0818 HH aide supervision elements Element
G1022 Discharge and transfer summaries Element
▼ 167030 Community Health Services 101 E 10th St Spencer IA 7 (Kansas City) 04/03/2024 629FE-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
▼ 167030 Community Health Services 101 E 10th St Spencer IA 7 (Kansas City) 04/14/2021 TI4J11 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
G0574 Plan of care must include the following Element
G0710 Provide services in the plan of care Element
▼ 167030 Community Health Services 101 E 10th St Spencer IA 7 (Kansas City) 05/23/2018 F83A11 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
G0574 Plan of care must include the following Element
G0580 Only as ordered by a physician Element
G0706 Interdisciplinary assessment of the patient Element
G1022 Discharge and transfer summaries Element
▼ 167034 Home Care Services Of Boone County 105 South Marshall Boone IA 7 (Kansas City) 12/10/2025 1DC376-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G1024 Authentication Standard
G0528 Health, psychosocial, functional, cognition Element
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0800 Services provided by HH aide Element
G0808 Onsite supervisory visit every 14 days Element
G0818 HH aide supervision elements Element
▼ 167034 Home Care Services Of Boone County 105 South Marshall Boone IA 7 (Kansas City) 11/02/2022 4F70E-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
G0574 Plan of care must include the following Element
G0580 Only as ordered by a physician Element