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
▼ 167220 Pella Regional Health Center 505 Union Street Pella IA 7 (Kansas City) 02/01/2023 5E975-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0039 EP Testing Requirements Standard
G0528 Health, psychosocial, functional, cognition Element
G0536 A review of all current medications Element
G0576 All orders recorded in plan of care Element
G1014 Interventions and patient response Element
G1022 Discharge and transfer summaries Element
▼ 167220 Pella Regional Health Center 505 Union Street Pella IA 7 (Kansas City) 02/19/2020 2G8111 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
E0037 EP Training Program 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
▼ 167226 Recover Health Of Iowa, Inc. 535 W Broadway Suite 201 Council Bluffs IA 7 (Kansas City) 12/31/2024 64D56-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0798 Home health aide assignments and duties Standard
G0574 Plan of care must include the following Element
G0800 Services provided by HH aide Element
G0818 HH aide supervision elements Element
▼ 167226 Recover Health Of Iowa, Inc. 535 W Broadway Suite 201 Council Bluffs IA 7 (Kansas City) 07/12/2022 4ED35-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0574 Plan of care must include the following Element
G0580 Only as ordered by a physician Element
▼ 167235 Quality Home Care Professionals Inc 101 East Marion Knoxville IA 7 (Kansas City) 01/24/2019 L9LB11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0009 Local, State, Tribal Collaboration Process Standard
E0017 HHA Comprehensive Assessment in Disaster Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0031 Emergency Officials Contact Information Standard
E0036 EP Training and Testing Standard
G0682 Infection Prevention Standard
G0768 Competency evaluation Standard
G0798 Home health aide assignments and duties Standard
G1024 Authentication Standard
G0482 Mistreatment, neglect or abuse Element
G0484 Document complaint and resolution 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
G0590 Promptly alert relevant physician of changes Element
G0616 Patient medication schedule/instructions Element
G0818 HH aide supervision elements Element
G1014 Interventions and patient response Element
G1022 Discharge and transfer summaries Element
▼ 167236 Hegg Home Health Care 1202 21st Avenue Rock Valley IA 7 (Kansas City) 10/25/2023 61138-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0702 Services by skilled professionals Standard
G0768 Competency evaluation Standard
G0574 Plan of care must include the following Element
G0800 Services provided by HH aide Element
G0808 Onsite supervisory visit every 14 days Element
▼ 167236 Hegg Home Health Care 1202 21st Avenue Rock Valley IA 7 (Kansas City) 11/04/2020 90EV11 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
E0019 Homebound HHA/Hospice Inform EP Officials Standard
E0021 HHA- Procedures for Follow up Staff/Pts. Standard
E0037 EP Training Program Standard
G0572 Plan of care Standard
G0768 Competency evaluation Standard
G0414 HHA administrator contact information Element
G0528 Health, psychosocial, functional, cognition Element
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
G0800 Services provided by HH aide Element
G0818 HH aide supervision elements Element
G1022 Discharge and transfer summaries Element
▼ 167237 County Of Bremer 403 3rd Street Se Waverly IA 7 (Kansas City) 10/31/2018 TIRU11 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
E0019 Homebound HHA/Hospice Inform EP Officials Standard
E0021 HHA- Procedures for Follow up Staff/Pts. Standard
E0036 EP Training and Testing Standard
G0528 Health, psychosocial, functional, cognition Element
G0536 A review of all current medications Element
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
G0618 Treatments and therapy services Element
G0620 Other pertinent instructions Element
G0710 Provide services in the plan of care Element
G1012 Required items in clinical record Element
▼ 167239 Home Sweet Home Care 16 West Sixth Street Atlantic IA 7 (Kansas City) 02/11/2025 651D5-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0009 Local, State, Tribal Collaboration Process Standard
E0021 HHA- Procedures for Follow up Staff/Pts. Standard
E0032 Primary/Alternate Means for Communication Standard
E0039 EP Testing Requirements Standard
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
G0584 Verbal orders Element
G1022 Discharge and transfer summaries Element
▼ 167239 Home Sweet Home Care 16 West Sixth Street Atlantic IA 7 (Kansas City) 06/29/2022 4EBA2-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
E0007 EP Program Patient Population Standard
E0009 Local, State, Tribal Collaboration Process Standard
E0021 HHA- Procedures for Follow up Staff/Pts. Standard
E0023 Policies/Procedures for Medical Documentation Standard
E0029 Development of Communication Plan Standard
E0031 Emergency Officials Contact Information Standard
E0032 Primary/Alternate Means for Communication Standard
E0033 Methods for Sharing Information Standard
E0034 Information on Occupancy/Needs Standard
E0039 EP Testing Requirements Standard
G0572 Plan of care Standard
G0682 Infection Prevention Standard
G0768 Competency evaluation Standard
G1024 Authentication Standard
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
G0800 Services provided by HH aide Element
G1022 Discharge and transfer summaries Element