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
▼ 057494 Redlands Community Hosp H C 350 Terracina Blvd Redlands CA 9 (San Francisco) 08/19/2021 NGP711 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0520 5 calendar days after start of care Element
▼ 057495 Era Home Health Services, Inc. 270 W Badillo St Covina CA 9 (San Francisco) 06/26/2022 4EEC7-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0682 Infection Prevention Standard
G0522 Eligibility for Medicare home health benefit Element
G0536 A review of all current medications Element
G0710 Provide services in the plan of care Element
▼ 057495 Era Home Health Services, Inc. 270 W Badillo St Covina CA 9 (San Francisco) 01/30/2019 DRT811 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0536 A review of all current medications Element
▼ 057497 Prime Nursing Services 3250 Wilshire Blvd Ste 1008 Los Angeles CA 9 (San Francisco) 01/16/2022 382DD-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0004 Develop EP Plan, Review and Update Annually Standard
G0536 A review of all current medications Element
G0580 Only as ordered by a physician Element
G0590 Promptly alert relevant physician of changes Element
G0710 Provide services in the plan of care Element
G0716 Preparing clinical notes Element
▼ 057517 Accentcare Home Health Of California, Inc. 3170 Crow Canyon Place, Suite 270 San Ramon CA 9 (San Francisco) 01/28/2022 382CA-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0570 Care planning, coordination, quality of care Condition
G0572 Plan of care Standard
G0682 Infection Prevention Standard
G0412 Written notice of patient's rights Element
G0536 A review of all current medications Element
G0588 Reviewed, revised by physician every 60 days Element
G0590 Promptly alert relevant physician of changes Element
▼ 057517 Accentcare Home Health Of California, Inc. 3170 Crow Canyon Place, Suite 270 San Ramon CA 9 (San Francisco) 04/25/2019 08PQ11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0434 Participate in care Element
G0524 Therapy services determine eligibility Element
G0536 A review of all current medications Element
▼ 057524 Mad River Comm Hosp H C Srvs 4605 Valley West Blvd Arcata CA 9 (San Francisco) 02/08/2019 SFE211 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0580 Only as ordered by a physician Element
G0606 Integrate all services Element
G0808 Onsite supervisory visit every 14 days Element
▼ 057537 Western Health Resources 2796 Sycamore Drive, Suite 100 Simi Valley CA 9 (San Francisco) 04/14/2022 387EA-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0614 Visit schedule Element
G0718 Communication with physicians Element
G0952 Ensure that HHA employs qualified personnel Element
▼ 057537 Western Health Resources 2796 Sycamore Drive, Suite 100 Simi Valley CA 9 (San Francisco) 02/20/2018 NZVZ11 Recertification
Deficiency Tag Deficiency Description Tag Type
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
G0590 Promptly alert relevant physician of changes Element
▼ 057564 Accentcare Home Health Of California, Inc 5050 Murphy Canyon Road, Suite 202 San Diego CA 9 (San Francisco) 10/14/2021 WVWF11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0682 Infection Prevention Standard