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
▼ 237243 Northern Home Care, Inc 42 W 2nd St #3 Pentwater MI 5 (Chicago) 01/09/2018 GENC11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0168 SKILLED NURSING SERVICES Condition
G0159 PLAN OF CARE Standard
G0170 SKILLED NURSING SERVICES Standard
G0172 DUTIES OF THE REGISTERED NURSE Standard
G0176 DUTIES OF THE REGISTERED NURSE Standard
G0224 ASSIGNMENT & DUTIES OF HOME HEALTH AIDE Standard
G0236 CLINICAL RECORDS Standard
G0250 CLINICAL RECORD REVIEW Standard
G0337 DRUG REGIMEN REVIEW Standard
▼ 237244 Family Care Choice & Services, Inc 23800 West 10 Mile Rd, Suite 108 Southfield MI 5 (Chicago) 09/22/2022 4F675-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0001 Establishment of the Emergency Program (EP) Condition
G0570 Care planning, coordination, quality of care Condition
G0640 Quality assessment/performance improvement Condition
G0680 Infection prevention and control Condition
G0940 Organization and administration of services Condition
E0004 Develop EP Plan, Review and Update Annually Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0029 Development of Communication Plan Standard
E0032 Primary/Alternate Means for Communication Standard
E0039 EP Testing Requirements Standard
G0572 Plan of care Standard
G0578 Conformance with physician orders Standard
G0642 Program scope Standard
G0644 Program data Standard
G0646 Program activities Standard
G0654 Track adverse patient events Standard
G0658 Performance improvement projects Standard
G0660 Executive responsibilities for QAPI Standard
G0682 Infection Prevention Standard
G0684 Infection control Standard
G0942 Governing body 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
G0648 High risk, high volume, or problem-prone area Element
G0718 Communication with physicians Element
G0954 Ensures qualified pre-designated person Element
G0968 Assure implementation of plan of care Element
G1022 Discharge and transfer summaries Element
▼ 237244 Family Care Choice & Services, Inc 23800 West 10 Mile Rd, Suite 108 Southfield MI 5 (Chicago) 09/27/2019 LHRF11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0001 Establishment of the Emergency Program (EP) Condition
G0570 Care planning, coordination, quality of care Condition
E0009 Local, State, Tribal Collaboration Process Standard
E0021 HHA- Procedures for Follow up Staff/Pts. Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0029 Development of Communication Plan Standard
E0039 EP Testing Requirements Standard
G0572 Plan of care Standard
G0686 Infection control education Standard
G1028 Protection of records Standard
G0528 Health, psychosocial, functional, cognition Element
G0536 A review of all current medications Element
G0954 Ensures qualified pre-designated person Element
G1022 Discharge and transfer summaries Element
▼ 237252 Global Home Care, Inc 1883 East Maple Rd. Troy MI 5 (Chicago) 01/05/2022 381F1-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0001 Establishment of the Emergency Program (EP) Condition
G0406 Patient rights Condition
G0680 Infection prevention and control Condition
E0013 Development of EP Policies and Procedures Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0029 Development of Communication Plan Standard
E0036 EP Training and Testing Standard
G0684 Infection control Standard
G0686 Infection control education Standard
G0454 HHA can no longer meet the patient's needs Element
G0482 Mistreatment, neglect or abuse Element
G0514 RN performs assessment Element
G0710 Provide services in the plan of care Element
G1022 Discharge and transfer summaries Element
▼ 237262 Michigan In-Home Partner-Iii, Llc 901 W Sharon Ave, Suite 3 Houghton MI 5 (Chicago) 07/10/2024 63893-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
G0528 Health, psychosocial, functional, cognition Element
G0710 Provide services in the plan of care Element
G1022 Discharge and transfer summaries Element
▼ 237262 Michigan In-Home Partner-Iii, Llc 901 W Sharon Ave, Suite 3 Houghton MI 5 (Chicago) 03/06/2024 62597-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0718 Communication with physicians Element
▼ 237262 Michigan In-Home Partner-Iii, Llc 901 W Sharon Ave, Suite 3 Houghton MI 5 (Chicago) 07/16/2021 PE9S11 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
G0798 Home health aide assignments and duties Standard
G0434 Participate in care Element
G0528 Health, psychosocial, functional, cognition Element
G0574 Plan of care must include the following Element
G0580 Only as ordered by a physician Element
G1022 Discharge and transfer summaries Element
▼ 237262 Michigan In-Home Partner-Iii, Llc 901 W Sharon Ave, Suite 3 Houghton MI 5 (Chicago) 07/19/2018 T7O711 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
E0009 Local, State, Tribal Collaboration Process Standard
E0037 EP Training Program Standard
G0798 Home health aide assignments and duties Standard
G0444 State toll free HH telephone hotline Element
G0446 Contact info Federal/State-funded entities Element
G0528 Health, psychosocial, functional, cognition Element
G0574 Plan of care must include the following Element
▼ 237268 Caring Nurses Of Michigan, Inc 803 Big Beaver Rd, Suite 357 Troy MI 5 (Chicago) 03/26/2025 659C5-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0001 Establishment of the Emergency Program (EP) Condition
G0640 Quality assessment/performance improvement Condition
E0004 Develop EP Plan, Review and Update Annually Standard
E0006 Plan Based on All Hazards Risk Assessment Standard
E0013 Development of EP Policies and Procedures Standard
E0029 Development of Communication Plan Standard
E0030 Names and Contact Information Standard
E0036 EP Training and Testing Standard
E0037 EP Training Program Standard
G0572 Plan of care Standard
G0654 Track adverse patient events Standard
G0658 Performance improvement projects Standard
G0660 Executive responsibilities for QAPI Standard
G0684 Infection control Standard
G0704 Responsibilities of skilled professionals Standard
G0768 Competency evaluation Standard
G0774 12 hours inservice every 12 months Standard
G0813 Basis and Scope Standard
G0942 Governing body Standard
G0442 Written notice for non-covered care Element
G0514 RN performs assessment Element
G0534 Patient's needs Element
G0536 A review of all current medications Element
G0538 Primary caregiver(s), if any 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
G0584 Verbal orders Element
G0716 Preparing clinical notes Element
G0950 Ensure clinical manager is available Element
G1012 Required items in clinical record Element
G1016 Goals in the patient's plans of care Element
G1022 Discharge and transfer summaries Element
▼ 237268 Caring Nurses Of Michigan, Inc 803 Big Beaver Rd, Suite 357 Troy MI 5 (Chicago) 03/24/2022 3871A-H1 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
G1008 Clinical records Condition
E0030 Names and Contact Information Standard
E0037 EP Training Program Standard
G0686 Infection control education Standard
G0514 RN performs assessment Element
G0536 A review of all current medications Element
G0550 At discharge Element
G0574 Plan of care must include the following Element
G0590 Promptly alert relevant physician of changes Element
G0706 Interdisciplinary assessment of the patient Element
G0708 Development and evaluation of plan of care Element
G0710 Provide services in the plan of care Element
G0716 Preparing clinical notes Element
G0962 Coordinate patient care Element
G0968 Assure implementation of plan of care Element
G1012 Required items in clinical record Element
G1022 Discharge and transfer summaries Element