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
▼ 239115 All Americans Home Health Care 1397 S Linden Rd, Ste D Flint MI 5 (Chicago) 05/24/2019 GPWZ11 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
G0798 Home health aide assignments and duties Standard
▼ 239117 Kaizen Home Care, Inc 40500 Ann Arbor Rd. E, Ste 103lla Plymouth MI 5 (Chicago) 06/27/2025 66784-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
G0536 A review of all current medications Element
G1012 Required items in clinical record Element
▼ 239120 Nationwide Home Healthcare, Inc 26645 W 12 Mile Rd, Suite #212 Southfield MI 5 (Chicago) 06/21/2019 AVM411 Recertification, Sample Validation
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
G0982 Skilled services furnished Standard
G0710 Provide services in the plan of care Element
G1022 Discharge and transfer summaries Element
▼ 239122 T.L.C. Home Healthcare, Inc 30600 Northwestern Hwy, Suite 105 Farmington Hills MI 5 (Chicago) 03/03/2023 5F242-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
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
G0940 Organization and administration of services Condition
E0037 EP Training Program 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
G0684 Infection control Standard
G0687 COVID-19 Vaccination of Home Health Agency staff Standard
G0768 Competency evaluation Standard
G0434 Participate in care 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
G0550 At discharge Element
G0574 Plan of care must include the following Element
G0576 All orders recorded in plan of care Element
G0618 Treatments and therapy services Element
G0648 High risk, high volume, or problem-prone area Element
G0706 Interdisciplinary assessment of the patient Element
G0710 Provide services in the plan of care Element
G0716 Preparing clinical notes Element
G0950 Ensure clinical manager is available Element
G0954 Ensures qualified pre-designated person Element
G0960 Make patient and personnel assignments, Element
G0966 Assure patient needs are continually assessed Element
G1022 Discharge and transfer summaries Element
▼ 239122 T.L.C. Home Healthcare, Inc 30600 Northwestern Hwy, Suite 105 Farmington Hills MI 5 (Chicago) 11/06/2019 X0VD11 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
G0514 RN performs assessment 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
G0808 Onsite supervisory visit every 14 days Element
G1012 Required items in clinical record Element
G1022 Discharge and transfer summaries Element
▼ 239125 Amazing Care Home Health Services, Inc 1663 Stephenson Hwy Ste 207 Troy MI 5 (Chicago) 04/24/2025 65EE6-H1 Recertification
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
E0036 EP Training and Testing Standard
G0572 Plan of care Standard
G0682 Infection Prevention Standard
G0704 Responsibilities of skilled professionals Standard
G0982 Skilled services furnished Standard
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G1016 Goals in the patient's plans of care Element
G1022 Discharge and transfer summaries Element
▼ 239125 Amazing Care Home Health Services, Inc 1663 Stephenson Hwy Ste 207 Troy MI 5 (Chicago) 06/08/2022 4ED2E-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
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
G1012 Required items in clinical record Element
▼ 239125 Amazing Care Home Health Services, Inc 1663 Stephenson Hwy Ste 207 Troy MI 5 (Chicago) 06/12/2019 TWL511 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0037 EP Training Program Standard
E0039 EP Testing Requirements Standard
G0572 Plan of care Standard
G0644 Program data Standard
G0658 Performance improvement projects Standard
G0446 Contact info Federal/State-funded entities Element
▼ 239131 Health Source Home Care, Inc 1100 Owendale Dr, Suite H Troy MI 5 (Chicago) 11/03/2022 5E1C8-H1 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
G0528 Health, psychosocial, functional, cognition Element
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G1022 Discharge and transfer summaries Element
▼ 239131 Health Source Home Care, Inc 1100 Owendale Dr, Suite H Troy MI 5 (Chicago) 11/08/2019 HAWB11 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
G0544 Update of the comprehensive assessment Standard
G0574 Plan of care must include the following Element