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
▼ 237514 Ultimacare Home Health, Inc 2785 Garfield Rd N, Suite C Traverse City MI 5 (Chicago) 03/15/2023 5F3D4-H1 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
G0574 Plan of care must include the following Element
▼ 237514 Ultimacare Home Health, Inc 2785 Garfield Rd N, Suite C Traverse City MI 5 (Chicago) 03/11/2020 5MEK11 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
G0450 Access to auxiliary aids and language service Element
G0486 Protect patient during investigation 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
▼ 237515 Michigan Home Health Services, Inc 33730 Freedom Road, Suite A Farmington Hills MI 5 (Chicago) 04/18/2024 62BC6-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
G0536 A review of all current medications Element
G0592 Revised plan of care Element
G1022 Discharge and transfer summaries Element
▼ 237515 Michigan Home Health Services, Inc 33730 Freedom Road, Suite A Farmington Hills MI 5 (Chicago) 04/23/2021 L8C611 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
E0001 Establishment of the Emergency Program (EP) Condition
G0406 Patient rights Condition
G0510 Comprehensive Assessment of Patients Condition
G0640 Quality assessment/performance improvement Condition
G0750 Home health aide services Condition
G1008 Clinical records Condition
G1050 Personnel qualifications Condition
E0004 Develop EP Plan, Review and Update Annually Standard
E0006 Plan Based on All Hazards Risk Assessment Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0030 Names and Contact Information Standard
E0037 EP Training Program Standard
E0039 EP Testing Requirements Standard
G0642 Program scope 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
G0768 Competency evaluation Standard
G0774 12 hours inservice every 12 months Standard
G0982 Skilled services furnished Standard
G1028 Protection of records Standard
G0434 Participate in care Element
G0442 Written notice for non-covered care Element
G0446 Contact info Federal/State-funded entities Element
G0480 Treatment or care Element
G0528 Health, psychosocial, functional, cognition Element
G0534 Patient's needs Element
G0536 A review of all current medications Element
G0580 Only as ordered by a physician Element
G0622 Name/contact information of clinical manager Element
G0800 Services provided by HH aide Element
G0812 Direct observation every 12 months Element
G1022 Discharge and transfer summaries Element
▼ 237516 Friman Home Health Services 42000 Koppernick Rd, Suite A-7 Canton MI 5 (Chicago) 02/10/2022 38417-H1 Focused Infection Control, 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
G1022 Discharge and transfer summaries Element
▼ 237525 Royale Home Health Care, Inc 20600 Eureka Rd, Suite 705a Taylor MI 5 (Chicago) 05/30/2025 66382-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
G0940 Organization and administration of services Condition
E0030 Names and Contact Information Standard
E0037 EP Training Program Standard
E0039 EP Testing Requirements Standard
G0572 Plan of care Standard
G0682 Infection Prevention Standard
G0982 Skilled services furnished 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
G0590 Promptly alert relevant physician of changes Element
G0622 Name/contact information of clinical manager Element
G0710 Provide services in the plan of care Element
G0714 Patient and caregiver education Element
G0948 Responsible for all day-to-day operations Element
G0954 Ensures qualified pre-designated person Element
G0962 Coordinate patient care Element
G1014 Interventions and patient response Element
G1022 Discharge and transfer summaries Element
▼ 237525 Royale Home Health Care, Inc 20600 Eureka Rd, Suite 705a Taylor MI 5 (Chicago) 06/23/2022 4EE0B-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
G0640 Quality assessment/performance improvement Condition
G0578 Conformance with physician orders Standard
G0642 Program scope Standard
G0644 Program data Standard
G0654 Track adverse patient events Standard
G0658 Performance improvement projects Standard
G0660 Executive responsibilities for QAPI Standard
G0687 COVID-19 Vaccination of Home Health Agency staff Standard
G0976 Services under arrangement Standard
G1062 Occupational Therapist 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
G0648 High risk, high volume, or problem-prone area Element
G0650 Incidence, prevalence, severity of problems Element
G0706 Interdisciplinary assessment of the patient Element
G0710 Provide services in the plan of care Element
G0754 A qualified HH aide successfully completed: Element
G0978 Must have a written agreement Element
G1012 Required items in clinical record Element
G1022 Discharge and transfer summaries Element
▼ 237526 Caring Choice Network, Inc 23800 W 10 Mile Rd, Suite 155 Southfield MI 5 (Chicago) 01/31/2025 652E7-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0037 EP Training Program Standard
G0574 Plan of care must include the following Element
▼ 237526 Caring Choice Network, Inc 23800 W 10 Mile Rd, Suite 155 Southfield MI 5 (Chicago) 02/17/2022 37ED2-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
G1022 Discharge and transfer summaries Element
▼ 237526 Caring Choice Network, Inc 23800 W 10 Mile Rd, Suite 155 Southfield MI 5 (Chicago) 02/14/2019 TF0O11 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
E0009 Local, State, Tribal Collaboration Process Standard
E0017 HHA Comprehensive Assessment in Disaster Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0031 Emergency Officials Contact Information Standard
E0034 Information on Occupancy/Needs Standard
E0039 EP Testing Requirements Standard
G0424 Exercise of rights Standard
G0526 Content of the comprehensive assessment Standard
G0572 Plan of care Standard
G0642 Program scope Standard
G0654 Track adverse patient events Standard
G0658 Performance improvement projects Standard
G0660 Executive responsibilities for QAPI Standard
G0768 Competency evaluation Standard
G1024 Authentication Standard
G0536 A review of all current medications Element
G0538 Primary caregiver(s), if any Element
G0540 The patient's representative (if any); Element
G0574 Plan of care must include the following Element
G0706 Interdisciplinary assessment of the patient Element
G0710 Provide services in the plan of care Element
G1022 Discharge and transfer summaries Element