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
▼ 237206 Heartland Home Care, Llc 100 Powell Dr, Suite 1and 3 Dundee MI 5 (Chicago) 03/12/2021 HQS711 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0526 Content of the comprehensive assessment Standard
G0572 Plan of care Standard
G0446 Contact info Federal/State-funded entities Element
G0574 Plan of care must include the following Element
G0580 Only as ordered by a physician Element
G0708 Development and evaluation of plan of care Element
G0800 Services provided by HH aide Element
▼ 237206 Heartland Home Care, Llc 100 Powell Dr, Suite 1and 3 Dundee MI 5 (Chicago) 04/26/2018 FEHZ11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0750 Home health aide services Condition
G0682 Infection Prevention Standard
G0768 Competency evaluation Standard
G0798 Home health aide assignments and duties Standard
G0534 Patient's needs 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
G0710 Provide services in the plan of care Element
G0800 Services provided by HH aide Element
G0808 Onsite supervisory visit every 14 days Element
G1022 Discharge and transfer summaries Element
▼ 237208 Atrio Home Health 2100 Raybrook Ave Se, Suite 303 Grand Rapids MI 5 (Chicago) 06/20/2025 666E0-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0580 Only as ordered by a physician Element
G1022 Discharge and transfer summaries Element
▼ 237212 Aspirus Vna Home Health, Inc 1101 N Elevation St Hancock MI 5 (Chicago) 12/01/2021 38012-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0514 RN performs assessment Element
▼ 237219 Uns Home Health Agency, Inc 5401 Portage Rd, Suite 1 Portage MI 5 (Chicago) 07/25/2024 63850-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0510 Comprehensive Assessment of Patients Condition
G0570 Care planning, coordination, quality of care Condition
G0680 Infection prevention and control Condition
G0700 Skilled professional services Condition
G1050 Personnel qualifications Condition
E0039 EP Testing Requirements Standard
G0572 Plan of care Standard
G0644 Program data Standard
G0682 Infection Prevention Standard
G0684 Infection control Standard
G0686 Infection control education Standard
G0704 Responsibilities of skilled professionals Standard
G1028 Protection of records Standard
G1064 Occupational Therapy Assistant Standard
G0434 Participate in care Element
G0520 5 calendar days after start of care Element
G0528 Health, psychosocial, functional, cognition 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
G0590 Promptly alert relevant physician of changes Element
G0716 Preparing clinical notes Element
G0718 Communication with physicians Element
G0864 Referral laboratory must be certified Element
G0962 Coordinate patient care Element
G0964 Coordinate referrals; Element
G1012 Required items in clinical record Element
G1022 Discharge and transfer summaries Element
▼ 237219 Uns Home Health Agency, Inc 5401 Portage Rd, Suite 1 Portage MI 5 (Chicago) 03/13/2024 6278C-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0580 Only as ordered by a physician Element
G1022 Discharge and transfer summaries Element
▼ 237219 Uns Home Health Agency, Inc 5401 Portage Rd, Suite 1 Portage MI 5 (Chicago) 06/29/2023 601BC-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0710 Provide services in the plan of care Element
G0952 Ensure that HHA employs qualified personnel Element
▼ 237219 Uns Home Health Agency, Inc 5401 Portage Rd, Suite 1 Portage MI 5 (Chicago) 03/10/2023 5F39E-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0570 Care planning, coordination, quality of care Condition
G0526 Content of the comprehensive assessment Standard
G0574 Plan of care must include the following Element
G0590 Promptly alert relevant physician of changes Element
▼ 237219 Uns Home Health Agency, Inc 5401 Portage Rd, Suite 1 Portage MI 5 (Chicago) 07/30/2021 B3GN11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0434 Participate in care Element
G0440 Payment from federally funded programs Element
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
G1012 Required items in clinical record Element
G1018 Contact information for the patient Element
G1022 Discharge and transfer summaries Element
▼ 237219 Uns Home Health Agency, Inc 5401 Portage Rd, Suite 1 Portage MI 5 (Chicago) 08/23/2018 0B9311 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
E0036 EP Training and Testing Standard
E0039 EP Testing Requirements Standard
G0642 Program scope Standard
G0528 Health, psychosocial, functional, cognition Element
G0574 Plan of care must include the following Element
G0606 Integrate all services Element
G0706 Interdisciplinary assessment of the patient Element
G0710 Provide services in the plan of care Element