S&C QCOR HHA 2567s
d QCOR: Quality, Certification and Oversight Reports. S&C QCOR  
Home  |  Help  |  Resources  |  FAQs  |  Site Map  
   
HHAs 2567s
Selection Criteria ▸

Time Interval

Please select the calendar year or years for which you would like data.

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
▼ 239255 Forever Home Care, Llc 39500 W 10 Mile Rd, Suite 109 Novi MI 5 (Chicago) 05/15/2024 630F2-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
E0039 EP Testing Requirements Standard
G0644 Program data Standard
G0658 Performance improvement projects Standard
G0798 Home health aide assignments and duties Standard
G0982 Skilled services furnished Standard
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
G0614 Visit schedule Element
G0710 Provide services in the plan of care Element
G1012 Required items in clinical record Element
G1022 Discharge and transfer summaries Element
▼ 239255 Forever Home Care, Llc 39500 W 10 Mile Rd, Suite 109 Novi MI 5 (Chicago) 07/01/2021 QQ9L11 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
G0528 Health, psychosocial, functional, cognition Element
G0574 Plan of care must include the following Element
▼ 239255 Forever Home Care, Llc 39500 W 10 Mile Rd, Suite 109 Novi MI 5 (Chicago) 08/02/2018 V78D11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
E0036 EP Training and Testing Standard
G0642 Program scope Standard
G0644 Program data Standard
G0660 Executive responsibilities for QAPI Standard
G0418 Patient's or legal representative's signature Element
G0444 State toll free HH telephone hotline Element
G0446 Contact info Federal/State-funded entities Element
▼ 239257 Miracle Care, Llc 2727 Second Ave, Suite 121 Detroit MI 5 (Chicago) 05/20/2021 YSXG11 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
G0578 Conformance with physician orders Standard
G0412 Written notice of patient's rights Element
G0414 HHA administrator contact information Element
G0416 OASIS privacy notice Element
G0444 State toll free HH telephone hotline Element
G0446 Contact info Federal/State-funded entities Element
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
G1012 Required items in clinical record Element
G1022 Discharge and transfer summaries Element
▼ 239264 Purple Heart Home Health Care, Inc 26645 West 12 Mile Road, Suite 102 Southfield MI 5 (Chicago) 06/13/2025 6662C-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
E0007 EP Program Patient Population Standard
E0017 HHA Comprehensive Assessment in Disaster Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0029 Development of Communication Plan Standard
E0032 Primary/Alternate Means for Communication Standard
E0037 EP Training Program Standard
E0039 EP Testing Requirements Standard
G0684 Infection control Standard
G0704 Responsibilities of skilled professionals Standard
G0768 Competency evaluation Standard
G0813 Basis and Scope Standard
G0434 Participate in care Element
G0436 Receive all services in plan of care Element
G0514 RN performs assessment Element
G0534 Patient's needs Element
G0574 Plan of care must include the following Element
G0580 Only as ordered by a physician Element
G0584 Verbal orders Element
G0590 Promptly alert relevant physician of changes Element
G0608 Coordinate care delivery Element
G0710 Provide services in the plan of care Element
G1022 Discharge and transfer summaries Element
▼ 239265 Safe Care Home Health Services, Llc 15223 Farmington Road, Suite 12 Livonia MI 5 (Chicago) 03/28/2025 65BAA-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
E0013 Development of EP Policies and Procedures Standard
G0572 Plan of care Standard
G0444 State toll free HH telephone hotline 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
G1012 Required items in clinical record Element
▼ 239265 Safe Care Home Health Services, Llc 15223 Farmington Road, Suite 12 Livonia MI 5 (Chicago) 05/15/2019 D6ZJ11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G1024 Authentication Standard
G0478 Investigate complaints made by patient Element
G0484 Document complaint and resolution Element
▼ 239265 Safe Care Home Health Services, Llc 15223 Farmington Road, Suite 12 Livonia MI 5 (Chicago) 01/25/2019 OIIB11 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
G0940 Organization and administration of services Condition
E0004 Develop EP Plan, Review and Update Annually Standard
E0006 Plan Based on All Hazards Risk Assessment Standard
E0007 EP Program Patient Population Standard
E0009 Local, State, Tribal Collaboration Process Standard
E0017 HHA Comprehensive Assessment in Disaster Standard
E0021 HHA- Procedures for Follow up Staff/Pts. Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0030 Names and Contact Information Standard
E0037 EP Training Program Standard
E0039 EP Testing Requirements Standard
G0642 Program scope Standard
G0658 Performance improvement projects Standard
G0660 Executive responsibilities for QAPI Standard
G0684 Infection control Standard
G0686 Infection control education Standard
G0724 Supervise skilled professional assistants Standard
G0862 Laboratory services/CLIA waivers Standard
G0976 Services under arrangement Standard
G0982 Skilled services furnished Standard
G0414 HHA administrator contact information Element
G0432 Make complaints to the HHA Element
G0536 A review of all current medications Element
G0550 At discharge Element
G0574 Plan of care must include the following Element
G0590 Promptly alert relevant physician of changes Element
G0622 Name/contact information of clinical manager Element
G0954 Ensures qualified pre-designated person Element
G0978 Must have a written agreement Element
G1014 Interventions and patient response Element
G1022 Discharge and transfer summaries Element
▼ 239272 Fine Home Health Care, Llc 31690 W 12 Mile Rd, Ste 102 Farmington Hills MI 5 (Chicago) 02/11/2026 1E2924-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G1008 Clinical records Condition
G0580 Only as ordered by a physician Element
G1012 Required items in clinical record Element
G1022 Discharge and transfer summaries Element
▼ 239272 Fine Home Health Care, Llc 31690 W 12 Mile Rd, Ste 102 Farmington Hills MI 5 (Chicago) 07/25/2025 1D1704-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0580 Only as ordered by a physician Element