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
▼ 237414 Ace Home Care Network, Inc 8424 E 12 Mile Rd, Suite B5 Warren MI 5 (Chicago) 08/31/2020 02X711 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0514 RN performs assessment Element
G1012 Required items in clinical record Element
▼ 237414 Ace Home Care Network, Inc 8424 E 12 Mile Rd, Suite B5 Warren MI 5 (Chicago) 05/24/2018 OKRR11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0578 Conformance with physician orders Standard
G0798 Home health aide assignments and duties Standard
G0710 Provide services in the plan of care Element
G0808 Onsite supervisory visit every 14 days Element
▼ 237423 Midwest Rockets Hh, Llc 1300 Esienhower Place, Suite 1390 Ann Arbor MI 5 (Chicago) 02/12/2018 6XLM11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0512 Standard: Initial assessment visit. Standard
G0682 Infection Prevention Standard
G0798 Home health aide assignments and duties Standard
G0444 State toll free HH telephone hotline Element
G0590 Promptly alert relevant physician of changes Element
G0706 Interdisciplinary assessment of the patient Element
G0710 Provide services in the plan of care Element
▼ 237424 Premium Home Health Care, Inc. 2015 East 15 Mile Road Sterling Heights MI 5 (Chicago) 03/15/2018 UHYP11 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
G0680 Infection prevention and control Condition
G0700 Skilled professional services Condition
G0750 Home health aide services Condition
E0004 Develop EP Plan, Review and Update Annually Standard
E0006 Plan Based on All Hazards Risk Assessment Standard
E0007 EP Program Patient Population Standard
E0009 Local, State, Tribal Collaboration Process Standard
E0021 HHA- Procedures for Follow up Staff/Pts. Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0032 Primary/Alternate Means for Communication Standard
E0033 Methods for Sharing Information Standard
E0037 EP Training Program Standard
E0039 EP Testing Requirements Standard
G0642 Program scope Standard
G0654 Track adverse patient events Standard
G0684 Infection control Standard
G0686 Infection control education Standard
G0774 12 hours inservice every 12 months Standard
G0798 Home health aide assignments and duties Standard
G0436 Receive all services in plan of care Element
G0536 A review of all current medications Element
G0708 Development and evaluation of plan of care Element
G0710 Provide services in the plan of care Element
G0716 Preparing clinical notes Element
G0800 Services provided by HH aide Element
G0808 Onsite supervisory visit every 14 days Element
G1022 Discharge and transfer summaries Element
▼ 237428 Excellacare Skilled Services 20853 Farmington Rd. Farmington Hills MI 5 (Chicago) 12/12/2025 1DDED3-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
E0029 Development of Communication Plan Standard
E0036 EP Training and Testing Standard
E0039 EP Testing Requirements Standard
G0642 Program scope Standard
G0644 Program data Standard
G0658 Performance improvement projects Standard
G0434 Participate in care Element
G0442 Written notice for non-covered care Element
G0446 Contact info Federal/State-funded entities Element
G0528 Health, psychosocial, functional, cognition Element
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0608 Coordinate care delivery Element
G0710 Provide services in the plan of care Element
G0714 Patient and caregiver education Element
G1012 Required items in clinical record Element
G1022 Discharge and transfer summaries Element
▼ 237428 Excellacare Skilled Services 20853 Farmington Rd. Farmington Hills MI 5 (Chicago) 12/01/2022 5E500-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0528 Health, psychosocial, functional, cognition Element
G0536 A review of all current medications Element
G0716 Preparing clinical notes Element
▼ 237428 Excellacare Skilled Services 20853 Farmington Rd. Farmington Hills MI 5 (Chicago) 06/16/2020 DO3C11 Focused Infection Control, Other-Fed
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
G0684 Infection control Standard
G0686 Infection control education Standard
▼ 237428 Excellacare Skilled Services 20853 Farmington Rd. Farmington Hills MI 5 (Chicago) 12/06/2019 3FC311 Recertification
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
G0574 Plan of care must include the following Element
G0808 Onsite supervisory visit every 14 days Element
G1012 Required items in clinical record Element
▼ 237431 Visiting Nurse Association Of Saginaw 515 N Michigan Ave Saginaw MI 5 (Chicago) 03/26/2026 22BD22-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0434 Participate in care Element
G0466 Make efforts to resolve the problem(s) Element
▼ 237434 Qcn Hh, Inc 1938 Woodslee Dr Troy MI 5 (Chicago) 06/17/2025 666D4-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0940 Organization and administration of services Condition
G0948 Responsible for all day-to-day operations Element
G0950 Ensure clinical manager is available Element
G0954 Ensures qualified pre-designated person Element