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
▼ 047870 Kah Development 4, Llc 14 Arnold Springs Road, Suite C Melbourne AR 6 (Dallas) 05/28/2021 165S11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0710 Provide services in the plan of care Element
▼ 053106 Danny's Home Health Care, Inc 1539 Sawtelle Blvd. Suite Ph #22 Los Angeles CA 9 (San Francisco) 02/03/2020 JXCI11 Recertification, Sample Validation
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0526 Content of the comprehensive assessment Standard
G0660 Executive responsibilities for QAPI Standard
G0958 Clinical manager Standard
G0536 A review of all current medications Element
G0576 All orders recorded in plan of care Element
G0610 Patients receive education and training Element
G0710 Provide services in the plan of care Element
G0952 Ensure that HHA employs qualified personnel Element
▼ 053113 Maxim Healthcare Services, Inc 31 Rancho Camino Dr., Floor 2 Pomona CA 9 (San Francisco) 01/16/2025 65191-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0548 Within 48 hours of the patient's return Element
G0574 Plan of care must include the following Element
G0590 Promptly alert relevant physician of changes Element
▼ 053113 Maxim Healthcare Services, Inc 31 Rancho Camino Dr., Floor 2 Pomona CA 9 (San Francisco) 11/03/2023 61640-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0406 Patient rights Condition
G0940 Organization and administration of services Condition
G0430 Be free from abuse Element
G0482 Mistreatment, neglect or abuse Element
G0484 Document complaint and resolution Element
G0488 Immediate reporting of abuse by all staff Element
G0536 A review of all current medications Element
G0580 Only as ordered by a physician Element
G0610 Patients receive education and training Element
G0948 Responsible for all day-to-day operations Element
G0984 In accordance with current clinical practice Element
▼ 053129 Gateway Home Health Corp. 10 Crow Canyon Court, Suite 210 San Ramon CA 9 (San Francisco) 05/02/2024 63008-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0514 RN performs assessment Element
▼ 053129 Gateway Home Health Corp. 10 Crow Canyon Court, Suite 210 San Ramon CA 9 (San Francisco) 09/01/2023 3828E-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G1010 Contents of clinical record Standard
▼ 053134 Maxim Healthcare Services, Inc 27555 Ynez Rd Temecula CA 9 (San Francisco) 11/21/2025 1DC3BF-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0430 Be free from abuse Element
▼ 053134 Maxim Healthcare Services, Inc 27555 Ynez Rd Temecula CA 9 (San Francisco) 11/02/2021 37D9E-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0430 Be free from abuse Element
G0486 Protect patient during investigation Element
▼ 053135 Maxim Healthcare Services, Inc 34250 Gateway Drive, Ste 100 Palm Desert CA 9 (San Francisco) 12/20/2023 61C43-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0430 Be free from abuse Element
▼ 053135 Maxim Healthcare Services, Inc 34250 Gateway Drive, Ste 100 Palm Desert CA 9 (San Francisco) 06/14/2021 R06711 Complaint, Sample Validation
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0578 Conformance with physician orders Standard
G0684 Infection control Standard