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
▼ 237464 Crystal Home Healthcare 15819 Schoolcraft Rd. Detroit MI 5 (Chicago) 09/08/2022 4F536-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
G0510 Comprehensive Assessment of Patients Condition
G0570 Care planning, coordination, quality of care Condition
G0640 Quality assessment/performance improvement Condition
G0680 Infection prevention and control Condition
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
G0526 Content of the comprehensive assessment Standard
G0544 Update of the comprehensive assessment Standard
G0658 Performance improvement projects Standard
G0660 Executive responsibilities for QAPI Standard
G0682 Infection Prevention Standard
G0684 Infection control Standard
G0687 COVID-19 Vaccination of Home Health Agency staff Standard
G0942 Governing body Standard
G0982 Skilled services furnished Standard
G0534 Patient's needs Element
G0536 A review of all current medications Element
G0548 Within 48 hours of the patient's return Element
G0550 At discharge 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
G0706 Interdisciplinary assessment of the patient Element
G0710 Provide services in the plan of care Element
G0978 Must have a written agreement Element
G1012 Required items in clinical record Element
G1022 Discharge and transfer summaries Element
▼ 237469 Horizon Home Care 1001 Giesau Drive Ontonagon MI 5 (Chicago) 10/23/2024 6476D-H1 Complaint, 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
▼ 237469 Horizon Home Care 1001 Giesau Drive Ontonagon MI 5 (Chicago) 10/22/2021 1976F-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0704 Responsibilities of skilled professionals Standard
G0574 Plan of care must include the following Element
▼ 237480 Quality Rehabilitation Services, Llc 16931 19 Mile Road, Ste. 130 Clinton Township MI 5 (Chicago) 12/12/2025 1D81D9-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
G0682 Infection Prevention Standard
G0798 Home health aide assignments and duties Standard
G0434 Participate in care Element
G0486 Protect patient during investigation Element
G0514 RN performs assessment Element
G0528 Health, psychosocial, functional, cognition Element
G0534 Patient's needs 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
G0808 Onsite supervisory visit every 14 days Element
G1022 Discharge and transfer summaries Element
▼ 237480 Quality Rehabilitation Services, Llc 16931 19 Mile Road, Ste. 130 Clinton Township MI 5 (Chicago) 10/06/2022 4F7E6-H1 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
G0444 State toll free HH telephone hotline Element
G0528 Health, psychosocial, functional, cognition Element
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0716 Preparing clinical notes Element
G1022 Discharge and transfer summaries Element
▼ 237480 Quality Rehabilitation Services, Llc 16931 19 Mile Road, Ste. 130 Clinton Township MI 5 (Chicago) 10/11/2019 PVCJ11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0414 HHA administrator contact information Element
G0574 Plan of care must include the following Element
G0608 Coordinate care delivery Element
G0622 Name/contact information of clinical manager Element
G0716 Preparing clinical notes Element
G0718 Communication with physicians Element
G1012 Required items in clinical record Element
▼ 237485 Health Wise Home Health Care 17401 W 12 Mile Rd Lathrup Village MI 5 (Chicago) 03/14/2025 658FE-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0013 Development of EP Policies and Procedures Standard
G0544 Update of the comprehensive assessment Standard
G0768 Competency evaluation Standard
G0442 Written notice for non-covered care Element
G0514 RN performs assessment Element
G0530 Strengths, goals, and care preferences Element
G0542 Incorporate OASIS items Element
G0574 Plan of care must include the following Element
G0580 Only as ordered by a physician Element
G0710 Provide services in the plan of care Element
G0808 Onsite supervisory visit every 14 days Element
G1012 Required items in clinical record Element
G1022 Discharge and transfer summaries Element
▼ 237485 Health Wise Home Health Care 17401 W 12 Mile Rd Lathrup Village MI 5 (Chicago) 03/17/2022 386D0-H1 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
G0574 Plan of care must include the following Element
G1022 Discharge and transfer summaries Element
▼ 237485 Health Wise Home Health Care 17401 W 12 Mile Rd Lathrup Village MI 5 (Chicago) 04/05/2019 EFEC11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0578 Conformance with physician orders Standard
G0798 Home health aide assignments and duties Standard
G0548 Within 48 hours of the patient's return Element
G0574 Plan of care must include the following Element
G0800 Services provided by HH aide Element
G1022 Discharge and transfer summaries Element
▼ 237489 First Home Health Care, Inc 44968 Ford Rd, Ste B Canton MI 5 (Chicago) 05/19/2022 4EA44-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
G0510 Comprehensive Assessment of Patients Condition
G0570 Care planning, coordination, quality of care Condition
G0640 Quality assessment/performance improvement Condition
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
G0578 Conformance with physician orders Standard
G0642 Program scope Standard
G0644 Program data Standard
G0658 Performance improvement projects Standard
G0660 Executive responsibilities for QAPI Standard
G0684 Infection control Standard
G0982 Skilled services furnished Standard
G0414 HHA administrator contact information Element
G0446 Contact info Federal/State-funded entities Element
G0514 RN performs assessment 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
G1022 Discharge and transfer summaries Element