S&C QCOR HHA 2567s
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HHAs 2567s
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Time Interval

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Provider Characteristics

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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
▼ 057013 Visiting Nurse Association Of The Inland Counties 6235 River Crest Dr Ste L Riverside CA 9 (San Francisco) 11/29/2018 X8SK11 Complaint, Sample Validation
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0536 A review of all current medications Element
▼ 057018 Vna Of Greater Los Angeles, Inc 402 S Prospectors Rd Ste G-100 Diamond Bar CA 9 (San Francisco) 12/16/2022 5E8A1-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0687 COVID-19 Vaccination of Home Health Agency staff Standard
▼ 057018 Vna Of Greater Los Angeles, Inc 402 S Prospectors Rd Ste G-100 Diamond Bar CA 9 (San Francisco) 05/02/2019 O8FQ11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0536 A review of all current medications Element
G0580 Only as ordered by a physician Element
G0710 Provide services in the plan of care Element
▼ 057021 Vna Of Orange County Llc 17682 Mitchell N Suite 100 Irvine CA 9 (San Francisco) 09/13/2019 UQR911 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
E0021 HHA- Procedures for Follow up Staff/Pts. Standard
E0023 Policies/Procedures for Medical Documentation Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0033 Methods for Sharing Information Standard
G0572 Plan of care Standard
G0586 Review and revision of the plan of care Standard
G0798 Home health aide assignments and duties Standard
G1024 Authentication Standard
G0514 RN performs assessment Element
G0520 5 calendar days after start of care Element
G0536 A review of all current medications 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
G0584 Verbal orders Element
G0608 Coordinate care delivery Element
G0614 Visit schedule Element
G0714 Patient and caregiver education Element
G0716 Preparing clinical notes Element
G0948 Responsible for all day-to-day operations Element
G0984 In accordance with current clinical practice Element
G1022 Discharge and transfer summaries Element
▼ 057036 Gentiva Certified Healthcare Corporation 5341 Old Redwood Hwy, Suite 350 Petaluma CA 9 (San Francisco) 03/28/2019 PFUR11 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
E0019 Homebound HHA/Hospice Inform EP Officials Standard
E0021 HHA- Procedures for Follow up Staff/Pts. Standard
G0572 Plan of care Standard
G0768 Competency evaluation Standard
G0430 Be free from abuse Element
G0536 A review of all current medications Element
G0548 Within 48 hours of the patient's return Element
G0598 Discharge plans communication Element
G0718 Communication with physicians Element
G1012 Required items in clinical record Element
G1022 Discharge and transfer summaries Element
▼ 057040 Livingston Memorial Visiting Nurse Association 1996 Eastman Ave Ste 101 Ventura CA 9 (San Francisco) 08/24/2018 GPQI11 Recertification, Sample Validation
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0372 Encoding and transmitting OASIS Standard
G0544 Update of the comprehensive assessment Standard
G0572 Plan of care Standard
G0682 Infection Prevention Standard
G0478 Investigate complaints made by patient Element
G0536 A review of all current medications Element
G0584 Verbal orders Element
▼ 057071 Kaiser Foundation Hospital Home Health - San Francisco 4131 Geary Blvd, 4th Floor San Francisco CA 9 (San Francisco) 09/06/2024 64147-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0706 Interdisciplinary assessment of the patient Element
G0720 Participate in the HHA's QAPI program; Element
▼ 057072 Memorialcare Home Health, Llc 23382 Mill Creek Dr, Suite 205 Laguna Hills CA 9 (San Francisco) 06/22/2022 4ED3F-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
E0021 HHA- Procedures for Follow up Staff/Pts. Standard
E0023 Policies/Procedures for Medical Documentation Standard
E0030 Names and Contact Information Standard
E0031 Emergency Officials Contact Information Standard
E0037 EP Training Program Standard
G0644 Program data 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
G0576 All orders recorded in plan of care Element
G0584 Verbal orders Element
G0602 Communication with all physicians Element
G0610 Patients receive education and training Element
G0614 Visit schedule Element
G0710 Provide services in the plan of care Element
G0716 Preparing clinical notes Element
G0726 Nursing services supervised by RN Element
G0984 In accordance with current clinical practice Element
G1022 Discharge and transfer summaries Element
▼ 057072 Memorialcare Home Health, Llc 23382 Mill Creek Dr, Suite 205 Laguna Hills CA 9 (San Francisco) 03/30/2018 5KZH11 Complaint, 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
G0700 Skilled professional services Condition
G0940 Organization and administration of services Condition
E0019 Homebound HHA/Hospice Inform EP Officials Standard
E0021 HHA- Procedures for Follow up Staff/Pts. Standard
E0023 Policies/Procedures for Medical Documentation Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0033 Methods for Sharing Information Standard
E0034 Information on Occupancy/Needs Standard
E0037 EP Training Program Standard
E0042 Integrated EP Program Standard
G0372 Encoding and transmitting OASIS Standard
G0942 Governing body Standard
G1024 Authentication Standard
G0478 Investigate complaints made by patient Element
G0520 5 calendar days after start of care Element
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
G0580 Only as ordered by a physician Element
G0584 Verbal orders Element
G0608 Coordinate care delivery Element
G0614 Visit schedule Element
G0616 Patient medication schedule/instructions Element
G0618 Treatments and therapy services Element
G0710 Provide services in the plan of care Element
G0716 Preparing clinical notes Element
G0726 Nursing services supervised by RN Element
G0800 Services provided by HH aide Element
G0808 Onsite supervisory visit every 14 days Element
G0948 Responsible for all day-to-day operations Element
G0984 In accordance with current clinical practice Element
G1022 Discharge and transfer summaries Element
▼ 057100 Loma Linda Univ Med Ctr Hha 11265 Mt View Ave Ste H14 Loma Linda CA 9 (San Francisco) 03/08/2019 64JN11 Other-Fed
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0514 RN performs assessment Element
G0536 A review of all current medications Element
G0590 Promptly alert relevant physician of changes Element
G0602 Communication with all physicians Element
G0706 Interdisciplinary assessment of the patient Element
G0710 Provide services in the plan of care Element
G1022 Discharge and transfer summaries Element