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
▼ 167288 Iowa Home Care, Llc 2500 University Avenue West Des Moines IA 7 (Kansas City) 11/01/2023 61136-H1 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
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
G0800 Services provided by HH aide Element
▼ 167288 Iowa Home Care, Llc 2500 University Avenue West Des Moines IA 7 (Kansas City) 10/28/2020 L6OQ11 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
G0528 Health, psychosocial, functional, cognition Element
G0574 Plan of care must include the following Element
G0580 Only as ordered by a physician Element
▼ 167288 Iowa Home Care, Llc 2500 University Avenue West Des Moines IA 7 (Kansas City) 10/01/2019 TUBH11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0432 Make complaints to the HHA Element
G0580 Only as ordered by a physician Element
▼ 167288 Iowa Home Care, Llc 2500 University Avenue West Des Moines IA 7 (Kansas City) 05/09/2019 N83O11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0406 Patient rights Condition
G0430 Be free from abuse Element
G0574 Plan of care must include the following Element
▼ 167290 Sunny Brook Home Care, Llc 400 Highland Street, Suite 102 Fairfield IA 7 (Kansas City) 02/08/2024 621BE-H1 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
G1024 Authentication Standard
G0528 Health, psychosocial, functional, cognition 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
G0808 Onsite supervisory visit every 14 days Element
G1012 Required items in clinical record Element
▼ 167290 Sunny Brook Home Care, Llc 400 Highland Street, Suite 102 Fairfield IA 7 (Kansas City) 05/17/2022 4EA6D-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G1028 Protection of records Standard
▼ 167290 Sunny Brook Home Care, Llc 400 Highland Street, Suite 102 Fairfield IA 7 (Kansas City) 02/03/2021 ASWQ11 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
E0037 EP Training Program Standard
E0039 EP Testing Requirements Standard
G0572 Plan of care Standard
G0768 Competency evaluation Standard
G0798 Home health aide assignments and duties Standard
G0440 Payment from federally funded programs Element
G0442 Written notice for non-covered care Element
G0546 Last 5 days of every 60 days unless: Element
G0548 Within 48 hours of the patient's return Element
G0550 At discharge 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
G0800 Services provided by HH aide Element
G1012 Required items in clinical record Element
G1022 Discharge and transfer summaries Element
▼ 167290 Sunny Brook Home Care, Llc 400 Highland Street, Suite 102 Fairfield IA 7 (Kansas City) 02/19/2019 EED011 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0434 Participate in care Element
G0484 Document complaint and resolution Element
G0486 Protect patient during investigation Element
G0614 Visit schedule Element
▼ 167290 Sunny Brook Home Care, Llc 400 Highland Street, Suite 102 Fairfield IA 7 (Kansas City) 04/02/2018 5DGC11 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
G0574 Plan of care must include the following Element
G0580 Only as ordered by a physician Element
G0710 Provide services in the plan of care Element
▼ 167292 Family Touch Home Health Llc 1601 Mcpherson Avenue Ste 500 Council Bluffs IA 7 (Kansas City) 12/04/2024 6435E-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
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
G0706 Interdisciplinary assessment of the patient Element
G1014 Interventions and patient response Element
G1022 Discharge and transfer summaries Element