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
▼ 239158 Ideal Home Health Services, Llc 8313 Holly Rd Ste C1 Grand Blanc MI 5 (Chicago) 11/22/2019 SS4K11 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
G0798 Home health aide assignments and duties Standard
G1024 Authentication Standard
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
G0710 Provide services in the plan of care Element
▼ 239158 Ideal Home Health Services, Llc 8313 Holly Rd Ste C1 Grand Blanc MI 5 (Chicago) 04/19/2018 HE5K11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0510 Comprehensive Assessment of Patients Condition
G0700 Skilled professional services Condition
G0940 Organization and administration of services Condition
G0526 Content of the comprehensive assessment Standard
G0544 Update of the comprehensive assessment Standard
G0684 Infection control Standard
G0798 Home health aide assignments and duties Standard
G0530 Strengths, goals, and care preferences Element
G0536 A review of all current medications Element
G0550 At discharge Element
G0574 Plan of care must include the following Element
G0588 Reviewed, revised by physician every 60 days Element
G0706 Interdisciplinary assessment of the patient Element
G0710 Provide services in the plan of care Element
G0718 Communication with physicians Element
G0726 Nursing services supervised by RN Element
G1022 Discharge and transfer summaries Element
▼ 239160 Alliance Care Services, Inc 5860 N Canton Center Rd, Suite 360 Canton MI 5 (Chicago) 02/26/2021 CW8X11 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
G0510 Comprehensive Assessment of Patients Condition
E0004 Develop EP Plan, Review and Update Annually Standard
E0006 Plan Based on All Hazards Risk Assessment Standard
E0030 Names and Contact Information Standard
E0037 EP Training Program Standard
G0682 Infection Prevention Standard
G0684 Infection control Standard
G0798 Home health aide assignments and duties Standard
G0982 Skilled services furnished Standard
G1028 Protection of records Standard
G0442 Written notice for non-covered care 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
G0710 Provide services in the plan of care Element
G0776 Inservice training supervised by RN Element
G0800 Services provided by HH aide Element
G1022 Discharge and transfer summaries Element
▼ 239161 Arbor Woods Home Health Care, Inc 1615 W Centre Ave, Suite 201 Portage MI 5 (Chicago) 10/20/2022 4F7FF-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0700 Skilled professional services Condition
E0006 Plan Based on All Hazards Risk Assessment Standard
E0039 EP Testing Requirements Standard
G0526 Content of the comprehensive assessment Standard
G0687 COVID-19 Vaccination of Home Health Agency staff Standard
G0704 Responsibilities of skilled professionals Standard
G0434 Participate in care Element
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0714 Patient and caregiver education Element
G0718 Communication with physicians Element
G1012 Required items in clinical record Element
G1022 Discharge and transfer summaries Element
▼ 239161 Arbor Woods Home Health Care, Inc 1615 W Centre Ave, Suite 201 Portage MI 5 (Chicago) 10/24/2019 VTO911 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
G0724 Supervise skilled professional assistants Standard
G1022 Discharge and transfer summaries Element
▼ 239169 Principal Home Healthcare, Llc 33469 W 14 Mile Rd, Suite 150 Farmington Hills MI 5 (Chicago) 03/17/2023 5F480-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
G0570 Care planning, coordination, quality of care Condition
G0640 Quality assessment/performance improvement Condition
G0680 Infection prevention and control Condition
G0700 Skilled professional services Condition
G0940 Organization and administration of services Condition
G1008 Clinical records Condition
E0004 Develop EP Plan, Review and Update Annually Standard
E0013 Development of EP Policies and Procedures Standard
E0031 Emergency Officials Contact Information Standard
E0036 EP Training and Testing Standard
E0039 EP Testing Requirements Standard
G0572 Plan of care Standard
G0642 Program scope Standard
G0644 Program data Standard
G0658 Performance improvement projects Standard
G0660 Executive responsibilities for QAPI Standard
G0684 Infection control Standard
G0686 Infection control education Standard
G0687 COVID-19 Vaccination of Home Health Agency staff Standard
G0704 Responsibilities of skilled professionals Standard
G0982 Skilled services furnished Standard
G1052 Administrator Standard
G0434 Participate in care Element
G0442 Written notice for non-covered care Element
G0528 Health, psychosocial, functional, cognition Element
G0534 Patient's needs Element
G0538 Primary caregiver(s), if any Element
G0580 Only as ordered by a physician Element
G0584 Verbal orders Element
G0588 Reviewed, revised by physician every 60 days Element
G0590 Promptly alert relevant physician of changes Element
G0608 Coordinate care delivery Element
G0622 Name/contact information of clinical manager Element
G0706 Interdisciplinary assessment of the patient Element
G0716 Preparing clinical notes Element
G0954 Ensures qualified pre-designated person Element
G0962 Coordinate patient care Element
G0966 Assure patient needs are continually assessed Element
G1012 Required items in clinical record Element
G1022 Discharge and transfer summaries Element
▼ 239169 Principal Home Healthcare, Llc 33469 W 14 Mile Rd, Suite 150 Farmington Hills MI 5 (Chicago) 09/17/2020 YL2211 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
G0446 Contact info Federal/State-funded entities Element
G0536 A review of all current medications Element
G0548 Within 48 hours of the patient's return Element
G1022 Discharge and transfer summaries Element
▼ 239170 Care First Home Health Services, Inc 1000 John R Rd, Suite 205 Troy MI 5 (Chicago) 04/18/2024 62BC8-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
G0682 Infection Prevention Standard
G0442 Written notice for non-covered care Element
G0514 RN performs assessment 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
G0708 Development and evaluation of plan of care Element
G0710 Provide services in the plan of care Element
G1022 Discharge and transfer summaries Element
▼ 239170 Care First Home Health Services, Inc 1000 John R Rd, Suite 205 Troy MI 5 (Chicago) 04/23/2021 PHNS11 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
G0700 Skilled professional services Condition
G0572 Plan of care Standard
G0704 Responsibilities of skilled professionals 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
G0714 Patient and caregiver education Element
G1012 Required items in clinical record Element
▼ 239170 Care First Home Health Services, Inc 1000 John R Rd, Suite 205 Troy MI 5 (Chicago) 11/05/2018 OV1811 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0940 Organization and administration of services Condition
G0526 Content of the comprehensive assessment Standard
G0958 Clinical manager Standard
G1024 Authentication Standard
G0946 Administrator appointed by governing body Element
G0948 Responsible for all day-to-day operations Element
G0950 Ensure clinical manager is available Element
G0954 Ensures qualified pre-designated person Element