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
▼ 237434 Qcn Hh, Inc 1938 Woodslee Dr Troy MI 5 (Chicago) 08/11/2022 4F2D3-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
G0700 Skilled professional services 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
E0036 EP Training and Testing Standard
G0642 Program scope Standard
G0644 Program data Standard
G0658 Performance improvement projects Standard
G0660 Executive responsibilities for QAPI Standard
G0514 RN performs assessment 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
G0706 Interdisciplinary assessment of the patient Element
G0710 Provide services in the plan of care Element
G0718 Communication with physicians Element
▼ 237434 Qcn Hh, Inc 1938 Woodslee Dr Troy MI 5 (Chicago) 09/13/2019 FJO011 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
E0017 HHA Comprehensive Assessment in Disaster Standard
E0019 Homebound HHA/Hospice Inform EP Officials Standard
E0021 HHA- Procedures for Follow up Staff/Pts. Standard
E0033 Methods for Sharing Information Standard
E0039 EP Testing Requirements Standard
G0572 Plan of care Standard
G0578 Conformance with physician orders Standard
G0642 Program scope Standard
G0682 Infection Prevention Standard
G0684 Infection control Standard
G0434 Participate in care Element
G0446 Contact info Federal/State-funded entities 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
G0590 Promptly alert relevant physician of changes Element
G0710 Provide services in the plan of care Element
G0728 Rehab services supervised by PT, OT Element
▼ 237435 Midwest Rockets Hh, Llc 564 Progress Street West Branch MI 5 (Chicago) 03/29/2018 4R5B11 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
G0536 A review of all current medications Element
▼ 237440 Beacon Home Care 415 Quay St, Suite A Port Huron MI 5 (Chicago) 02/08/2024 621FD-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0710 Provide services in the plan of care Element
G1022 Discharge and transfer summaries Element
▼ 237445 Dynamic Home Care, Inc 24001 Southfield Rd, Suite 205 Southfield MI 5 (Chicago) 12/19/2023 61BD9-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
G0680 Infection prevention and control Condition
G0940 Organization and administration of services Condition
E0006 Plan Based on All Hazards Risk Assessment Standard
E0013 Development of EP Policies and Procedures Standard
E0021 HHA- Procedures for Follow up Staff/Pts. Standard
E0030 Names and Contact Information Standard
E0036 EP Training and Testing Standard
E0039 EP Testing Requirements 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
G0528 Health, psychosocial, functional, cognition Element
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0648 High risk, high volume, or problem-prone area Element
G1012 Required items in clinical record Element
G1022 Discharge and transfer summaries Element
▼ 237445 Dynamic Home Care, Inc 24001 Southfield Rd, Suite 205 Southfield MI 5 (Chicago) 01/07/2021 F2GL11 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
G0510 Comprehensive Assessment of Patients Condition
G0570 Care planning, coordination, quality of care Condition
G0700 Skilled professional services Condition
G0750 Home health aide services Condition
G0940 Organization and administration of services Condition
E0024 Policies/Procedures-Volunteers and Staffing Standard
G0572 Plan of care Standard
G0768 Competency evaluation Standard
G0774 12 hours inservice every 12 months Standard
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
G0590 Promptly alert relevant physician of changes Element
G0608 Coordinate care delivery Element
G0610 Patients receive education and training 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
G0800 Services provided by HH aide Element
G0812 Direct observation every 12 months Element
G0962 Coordinate patient care Element
G0966 Assure patient needs are continually assessed Element
G0968 Assure implementation of plan of care Element
G1022 Discharge and transfer summaries Element
▼ 237445 Dynamic Home Care, Inc 24001 Southfield Rd, Suite 205 Southfield MI 5 (Chicago) 01/25/2018 CW0V11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0017 HHA Comprehensive Assessment in Disaster Standard
G0578 Conformance with physician orders Standard
G1016 Goals in the patient's plans of care Element
▼ 237446 Advanced Home Care, Inc 43184 Dequindre Rd, Suite 203 Sterling Heights MI 5 (Chicago) 03/19/2024 62770-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0574 Plan of care must include the following Element
G0708 Development and evaluation of plan of care Element
▼ 237446 Advanced Home Care, Inc 43184 Dequindre Rd, Suite 203 Sterling Heights MI 5 (Chicago) 03/12/2021 SE9811 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
G0526 Content of the comprehensive assessment Standard
G0684 Infection control Standard
G1024 Authentication Standard
G0414 HHA administrator contact information Element
G0446 Contact info Federal/State-funded entities Element
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0706 Interdisciplinary assessment of the patient Element
G1022 Discharge and transfer summaries Element
▼ 237447 Unicare Home Health System, Inc 34514 Dequindre Rd, Ste B Sterling Heights MI 5 (Chicago) 03/21/2024 627D2-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
G0578 Conformance with physician orders Standard
G0514 RN performs assessment Element
G0528 Health, psychosocial, functional, cognition Element
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0710 Provide services in the plan of care Element
G1012 Required items in clinical record Element
G1022 Discharge and transfer summaries Element