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
▼ 167140 Mercy Health Services Iowa Corporation 910 North Eisenhower Mason City IA 7 (Kansas City) 07/03/2024 63610-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G1012 Required items in clinical record Element
▼ 167140 Mercy Health Services Iowa Corporation 910 North Eisenhower Mason City IA 7 (Kansas City) 07/02/2019 SMOR11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0570 Care planning, coordination, quality of care Condition
E0021 HHA- Procedures for Follow up Staff/Pts. Standard
G0544 Update of the comprehensive assessment Standard
G0528 Health, psychosocial, functional, cognition 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
G0590 Promptly alert relevant physician of changes Element
G0608 Coordinate care delivery Element
G0706 Interdisciplinary assessment of the patient Element
G1022 Discharge and transfer summaries Element
▼ 167145 Mercy Health Services-Iowa Corp 250 Mercy Drive Dubuque IA 7 (Kansas City) 11/16/2021 37D83-H1 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
G0548 Within 48 hours of the patient's return Element
G0574 Plan of care must include the following Element
G0800 Services provided by HH aide Element
G1014 Interventions and patient response Element
G1022 Discharge and transfer summaries Element
▼ 167145 Mercy Health Services-Iowa Corp 250 Mercy Drive Dubuque IA 7 (Kansas City) 11/21/2018 38DC11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0528 Health, psychosocial, functional, cognition Element
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
▼ 167146 Burgess Health Center 1600 Diamond Street Onawa IA 7 (Kansas City) 02/07/2024 621C5-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0590 Promptly alert relevant physician of changes Element
G0706 Interdisciplinary assessment of the patient Element
▼ 167146 Burgess Health Center 1600 Diamond Street Onawa IA 7 (Kansas City) 02/11/2021 8Y9L11 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
E0017 HHA Comprehensive Assessment in Disaster Standard
G0440 Payment from federally funded programs Element
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0706 Interdisciplinary assessment of the patient Element
G1022 Discharge and transfer summaries Element
▼ 167146 Burgess Health Center 1600 Diamond Street Onawa IA 7 (Kansas City) 02/21/2018 AE8611 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0700 Skilled professional services Condition
G0798 Home health aide assignments and duties Standard
G1024 Authentication Standard
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
G0592 Revised plan of care Element
G0710 Provide services in the plan of care Element
G0718 Communication with physicians Element
G0814 Non-skilled direct observation every 60 days Element
▼ 167147 Unitypoint At Home 3731 University Ave Waterloo IA 7 (Kansas City) 05/10/2023 5F9CE-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0570 Care planning, coordination, quality of care Condition
G0750 Home health aide services Condition
G1008 Clinical records Condition
G0580 Only as ordered by a physician Element
G0800 Services provided by HH aide Element
G0804 Aides are members of interdisciplinary team Element
G1014 Interventions and patient response Element
▼ 167147 Unitypoint At Home 3731 University Ave Waterloo IA 7 (Kansas City) 05/17/2018 UNF911 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
E0017 HHA Comprehensive Assessment in Disaster Standard
E0037 EP Training Program Standard
G0684 Infection control Standard
G0942 Governing body Standard
G0970 Parent-branch relationship Standard
G0478 Investigate complaints made by patient Element
G0484 Document complaint and resolution Element
G0514 RN performs assessment Element
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0584 Verbal orders Element
G0710 Provide services in the plan of care Element
▼ 167148 Unitypoint At Home 11333 Aurora Avenue Urbandale IA 7 (Kansas City) 07/25/2024 6373A-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0576 All orders recorded in plan of care Element
G0592 Revised plan of care Element