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
▼ 239170 Care First Home Health Services, Inc 1000 John R Rd, Suite 205 Troy MI 5 (Chicago) 07/05/2018 DTUY11 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
G0680 Infection prevention and control Condition
G0750 Home health aide services Condition
E0004 Develop EP Plan, Review and Update Annually Standard
G0526 Content of the comprehensive assessment Standard
G0578 Conformance with physician orders Standard
G0642 Program scope Standard
G0644 Program data Standard
G0660 Executive responsibilities for QAPI Standard
G0682 Infection Prevention Standard
G0684 Infection control Standard
G0686 Infection control education Standard
G0768 Competency evaluation Standard
G0798 Home health aide assignments and duties Standard
G0942 Governing body Standard
G1028 Protection of records Standard
G0414 HHA administrator contact information Element
G0446 Contact info Federal/State-funded entities Element
G0520 5 calendar days after start of care Element
G0536 A review of all current medications Element
G0548 Within 48 hours of the patient's return Element
G0590 Promptly alert relevant physician of changes Element
G0622 Name/contact information of clinical manager Element
G0648 High risk, high volume, or problem-prone area Element
G0710 Provide services in the plan of care Element
G0766 HHA maintains documentation of training Element
G0808 Onsite supervisory visit every 14 days Element
G0946 Administrator appointed by governing body Element
G0954 Ensures qualified pre-designated person Element
G1012 Required items in clinical record Element
G1022 Discharge and transfer summaries Element
▼ 239172 Able Care, L L C 21790 Coolidge Hwy, Suite B-107 Oak Park MI 5 (Chicago) 01/26/2026 1E1617-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
G0572 Plan of care Standard
G0682 Infection Prevention Standard
G0798 Home health aide assignments and duties Standard
G0434 Participate in care Element
G0516 Skilled professional performs assessment Element
G0520 5 calendar days after start of care Element
G0528 Health, psychosocial, functional, cognition Element
G0574 Plan of care must include the following Element
G0592 Revised plan of care Element
G0726 Nursing services supervised by RN Element
G0728 Rehab services supervised by PT, OT Element
G0962 Coordinate patient care Element
G0964 Coordinate referrals; Element
G0968 Assure implementation of plan of care Element
G1012 Required items in clinical record Element
G1022 Discharge and transfer summaries Element
▼ 239172 Able Care, L L C 21790 Coolidge Hwy, Suite B-107 Oak Park MI 5 (Chicago) 01/05/2023 5E96A-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
G0680 Infection prevention and control Condition
G0700 Skilled professional services Condition
E0006 Plan Based on All Hazards Risk Assessment Standard
E0007 EP Program Patient Population Standard
E0009 Local, State, Tribal Collaboration Process Standard
E0029 Development of Communication Plan Standard
E0036 EP Training and Testing Standard
G0572 Plan of care Standard
G0684 Infection control Standard
G0687 COVID-19 Vaccination of Home Health Agency staff Standard
G0798 Home health aide assignments and duties Standard
G0982 Skilled services furnished Standard
G0434 Participate in care Element
G0442 Written notice for non-covered care Element
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
G0706 Interdisciplinary assessment of the patient Element
G0708 Development and evaluation of plan of care Element
G0710 Provide services in the plan of care Element
G0716 Preparing clinical notes Element
G0978 Must have a written agreement Element
▼ 239172 Able Care, L L C 21790 Coolidge Hwy, Suite B-107 Oak Park MI 5 (Chicago) 02/11/2020 67EU11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0850 Disclosure of ownership and management info. Standard
G0852 Information to the state survey agency Standard
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0718 Communication with physicians Element
▼ 239173 Diversity Home Care Services, Llc 1213 Mason St, Suite 5 Dearborn MI 5 (Chicago) 08/11/2023 60849-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
E0001 Establishment of the Emergency Program (EP) Condition
G0640 Quality assessment/performance improvement Condition
G0700 Skilled professional services Condition
E0004 Develop EP Plan, Review and Update Annually Standard
E0030 Names and Contact Information Standard
E0037 EP Training Program Standard
E0039 EP Testing Requirements Standard
G0544 Update of the comprehensive assessment Standard
G0642 Program scope Standard
G0644 Program data Standard
G0654 Track adverse patient events Standard
G0660 Executive responsibilities for QAPI Standard
G0682 Infection Prevention Standard
G0704 Responsibilities of skilled professionals Standard
G0798 Home health aide assignments and duties Standard
G0434 Participate in care Element
G0536 A review of all current medications Element
G0590 Promptly alert relevant physician of changes Element
G0622 Name/contact information of clinical manager Element
G0706 Interdisciplinary assessment of the patient Element
G0716 Preparing clinical notes Element
▼ 239184 Michigan Home Rehabilitation, Llc 501 Baldwin St Suite 203 Jenison MI 5 (Chicago) 09/26/2024 64398-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
G0528 Health, psychosocial, functional, cognition Element
G0574 Plan of care must include the following Element
G0590 Promptly alert relevant physician of changes Element
▼ 239184 Michigan Home Rehabilitation, Llc 501 Baldwin St Suite 203 Jenison MI 5 (Chicago) 10/01/2021 196EC-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
G0574 Plan of care must include the following Element
▼ 239191 Healthstar Home Care, Inc 8061 21 Mile Rd, Suite 1 Shelby Township MI 5 (Chicago) 06/10/2026 234C7D-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0036 EP Training and Testing Standard
G0686 Infection control education Standard
G0800 Services provided by HH aide Element
G1012 Required items in clinical record Element
G1022 Discharge and transfer summaries Element
▼ 239191 Healthstar Home Care, Inc 8061 21 Mile Rd, Suite 1 Shelby Township MI 5 (Chicago) 01/27/2023 5EC44-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0570 Care planning, coordination, quality of care Condition
G0640 Quality assessment/performance improvement Condition
G0700 Skilled professional services Condition
E0004 Develop EP Plan, Review and Update Annually Standard
E0006 Plan Based on All Hazards Risk Assessment Standard
G0572 Plan of care Standard
G0578 Conformance with physician orders Standard
G0644 Program data Standard
G0654 Track adverse patient events Standard
G0658 Performance improvement projects Standard
G0660 Executive responsibilities for QAPI Standard
G0684 Infection control Standard
G0704 Responsibilities of skilled professionals Standard
G0724 Supervise skilled professional assistants Standard
G0434 Participate in care 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
G0608 Coordinate care delivery Element
G0616 Patient medication schedule/instructions Element
G0656 Improvements are sustained Element
G0706 Interdisciplinary assessment of the patient 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
▼ 239191 Healthstar Home Care, Inc 8061 21 Mile Rd, Suite 1 Shelby Township MI 5 (Chicago) 09/29/2020 XCQV11 Focused Infection Control, Other-Fed
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0684 Infection control Standard