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
▼ 239191 Healthstar Home Care, Inc 8061 21 Mile Rd, Suite 1 Shelby Township MI 5 (Chicago) 03/12/2020 TC2Z11 Recertification
Deficiency Tag Deficiency Description Tag Type
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
G0680 Infection prevention and control Condition
G0750 Home health aide services 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
E0029 Development of Communication Plan Standard
E0030 Names and Contact Information Standard
E0036 EP Training and Testing 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
G0798 Home health aide assignments and duties Standard
G0436 Receive all services in plan of care Element
G0446 Contact info Federal/State-funded entities Element
G0484 Document complaint and resolution Element
G0536 A review of all current medications Element
G0538 Primary caregiver(s), if any Element
G0546 Last 5 days of every 60 days unless: 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
G0622 Name/contact information of clinical manager Element
G0800 Services provided by HH aide Element
G0812 Direct observation every 12 months Element
▼ 239192 Home Health Care Connections, L L C 2075 Fort St, Suite 200 Lincoln Park MI 5 (Chicago) 10/04/2023 611BF-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G1024 Authentication Standard
G0514 RN performs assessment Element
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G1022 Discharge and transfer summaries Element
▼ 239195 Total Care Home Health Services, Inc 24655 Southfield Rd, Suite 110 Southfield MI 5 (Chicago) 09/24/2020 X7DE11 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
G0572 Plan of care Standard
G0798 Home health aide assignments and duties Standard
G0446 Contact info Federal/State-funded entities Element
G0536 A review of all current medications Element
G0808 Onsite supervisory visit every 14 days Element
G0984 In accordance with current clinical practice Element
G1022 Discharge and transfer summaries Element
▼ 239199 Compassionate Home Health Services, Inc 35 S Johnson Ave, Suite 3b Pontiac MI 5 (Chicago) 06/15/2023 5FF15-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0544 Update of the comprehensive assessment Standard
G0976 Services under arrangement Standard
G0982 Skilled services furnished Standard
G0412 Written notice of patient's rights Element
G0414 HHA administrator contact information Element
G0434 Participate in care Element
G0442 Written notice for non-covered care Element
G0446 Contact info Federal/State-funded entities Element
G0450 Access to auxiliary aids and language service Element
G0514 RN performs assessment Element
G0528 Health, psychosocial, functional, cognition Element
G0536 A review of all current medications Element
G0550 At discharge Element
G0574 Plan of care must include the following Element
G0584 Verbal orders Element
G0622 Name/contact information of clinical manager Element
G0706 Interdisciplinary assessment of the patient Element
G0710 Provide services in the plan of care Element
G0716 Preparing clinical notes Element
G0978 Must have a written agreement Element
G1022 Discharge and transfer summaries Element
▼ 239199 Compassionate Home Health Services, Inc 35 S Johnson Ave, Suite 3b Pontiac MI 5 (Chicago) 11/23/2020 OMSU11 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
G0750 Home health aide services Condition
G0940 Organization and administration of services Condition
G0752 Home health aide qualifications Standard
G0768 Competency evaluation Standard
G0862 Laboratory services/CLIA waivers Standard
G0942 Governing body Standard
G0414 HHA administrator contact information Element
G0440 Payment from federally funded programs Element
G0446 Contact info Federal/State-funded entities Element
G0808 Onsite supervisory visit every 14 days Element
G0946 Administrator appointed by governing body Element
G0954 Ensures qualified pre-designated person Element
▼ 239206 Premier Home Health Solutions, Inc 671 E Big Beaver Rd, Suite 203 Troy MI 5 (Chicago) 01/07/2026 1DFB3C-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
G0406 Condition of Participation: Patient rights. Condition
E0006 Plan Based on All Hazards Risk Assessment Standard
E0013 Development of EP Policies and Procedures Standard
E0029 Development of Communication Plan Standard
E0030 Names and Contact Information Standard
E0036 EP Training and Testing Standard
E0037 EP Training Program Standard
E0039 EP Testing Requirements Standard
G0642 Program scope Standard
G0682 Infection Prevention Standard
G0686 Infection control education Standard
G0774 12 hours inservice every 12 months Standard
G0982 Skilled services furnished Standard
G0412 Written notice of patient's rights Element
G0414 HHA administrator contact information Element
G0418 Patient's or legal representative's signature Element
G0432 Make complaints to the HHA Element
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
G0622 Name/contact information of clinical manager Element
G0710 Provide services in the plan of care Element
G1012 Required items in clinical record Element
G1022 Discharge and transfer summaries Element
▼ 239206 Premier Home Health Solutions, Inc 671 E Big Beaver Rd, Suite 203 Troy MI 5 (Chicago) 12/15/2022 5E73B-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
G0514 RN performs assessment Element
G0534 Patient's needs Element
G0574 Plan of care must include the following Element
G1022 Discharge and transfer summaries Element
▼ 239206 Premier Home Health Solutions, Inc 671 E Big Beaver Rd, Suite 203 Troy MI 5 (Chicago) 06/17/2020 MFNV11 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
▼ 239206 Premier Home Health Solutions, Inc 671 E Big Beaver Rd, Suite 203 Troy MI 5 (Chicago) 01/08/2020 I3ES11 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
G0798 Home health aide assignments and duties Standard
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
G0808 Onsite supervisory visit every 14 days Element
▼ 239207 Care Plan, Inc 6 Park Lane Blvd, Suite 135 Dearborn MI 5 (Chicago) 01/06/2021 WMIA11 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
G0684 Infection control Standard
G0798 Home health aide assignments and duties Standard
G0580 Only as ordered by a physician Element