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
▼ 239140 Renaissance Home Healthcare Services, Inc 30445 Northwestern Highway, Suite 120 Farmington Hills MI 5 (Chicago) 12/05/2024 64C51-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
G0716 Preparing clinical notes Element
G1022 Discharge and transfer summaries Element
▼ 239140 Renaissance Home Healthcare Services, Inc 30445 Northwestern Highway, Suite 120 Farmington Hills MI 5 (Chicago) 12/16/2021 19721-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
G1022 Discharge and transfer summaries Element
▼ 239143 Atlantic Home Health Care, Inc 21701 W 11 Mile Rd, Suite 12 Southfield MI 5 (Chicago) 08/01/2025 1D2647-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
E0013 Development of EP Policies and Procedures Standard
E0017 HHA Comprehensive Assessment in Disaster Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0029 Development of Communication Plan Standard
E0030 Names and Contact Information Standard
E0037 EP Training Program Standard
E0039 EP Testing Requirements Standard
G0572 Plan of care 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
G0414 HHA administrator contact information Element
G0514 RN performs assessment Element
G0516 Skilled professional performs assessment Element
G0534 Patient's needs Element
G0574 Plan of care must include the following Element
G0622 Name/contact information of clinical manager Element
G0710 Provide services in the plan of care Element
G0978 Must have a written agreement Element
G1022 Discharge and transfer summaries Element
▼ 239143 Atlantic Home Health Care, Inc 21701 W 11 Mile Rd, Suite 12 Southfield MI 5 (Chicago) 10/27/2022 4F6F2-H2 Recertification
Deficiency Tag Deficiency Description Tag Type
G0686 Infection control education Standard
▼ 239143 Atlantic Home Health Care, Inc 21701 W 11 Mile Rd, Suite 12 Southfield MI 5 (Chicago) 09/26/2022 4F6F2-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
G0700 Skilled professional services 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
E0029 Development of Communication Plan Standard
E0036 EP Training and Testing Standard
G0644 Program data Standard
G0658 Performance improvement projects Standard
G0704 Responsibilities of skilled professionals Standard
G0944 Administrator must: Standard
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
G0726 Nursing services supervised by RN Element
G1022 Discharge and transfer summaries Element
▼ 239143 Atlantic Home Health Care, Inc 21701 W 11 Mile Rd, Suite 12 Southfield MI 5 (Chicago) 06/09/2020 OCNU11 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
G0684 Infection control Standard
G0686 Infection control education Standard
▼ 239143 Atlantic Home Health Care, Inc 21701 W 11 Mile Rd, Suite 12 Southfield MI 5 (Chicago) 08/08/2019 LRP511 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
G0718 Communication with physicians Element
G0808 Onsite supervisory visit every 14 days Element
▼ 239148 Extracare Home Health Services, Inc 2855 Coolidge Highway, Suite 106 Troy MI 5 (Chicago) 04/16/2026 22DB5A-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
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
E0013 Development of EP Policies and Procedures Standard
E0029 Development of Communication Plan Standard
E0030 Names and Contact Information Standard
G0544 Update of the comprehensive assessment Standard
G0572 Plan of care 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
G0686 Infection control education Standard
G0704 Responsibilities of skilled professionals Standard
G0798 Home health aide assignments and duties Standard
G0982 Skilled services furnished Standard
G1024 Authentication Standard
G0434 Participate in care Element
G0442 Written notice for non-covered care Element
G0528 Health, psychosocial, functional, cognition Element
G0530 Strengths, goals, and care preferences Element
G0534 Patient's needs Element
G0536 A review of all current medications Element
G0538 Primary caregiver(s), if any Element
G0574 Plan of care must include the following Element
G0576 All orders recorded in plan of care Element
G0580 Only as ordered by a physician Element
G0588 Reviewed, revised by physician every 60 days Element
G0616 Patient medication schedule/instructions Element
G0622 Name/contact information of clinical manager Element
G0656 Improvements are sustained Element
G0950 Ensure clinical manager is available Element
G0964 Coordinate referrals; Element
G0966 Assure patient needs are continually assessed Element
G0968 Assure implementation of plan of care Element
G1022 Discharge and transfer summaries Element
▼ 239148 Extracare Home Health Services, Inc 2855 Coolidge Highway, Suite 106 Troy MI 5 (Chicago) 11/02/2022 5E1CA-H1 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
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
G0964 Coordinate referrals; Element
G1022 Discharge and transfer summaries Element
▼ 239148 Extracare Home Health Services, Inc 2855 Coolidge Highway, Suite 106 Troy MI 5 (Chicago) 11/08/2019 INEY11 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
G0572 Plan of care Standard
G1024 Authentication Standard
G1028 Protection of records Standard
G0514 RN performs assessment 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
G1012 Required items in clinical record Element