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
▼ 239272 Fine Home Health Care, Llc 31690 W 12 Mile Rd, Ste 102 Farmington Hills MI 5 (Chicago) 04/11/2025 65CBF-H1 Complaint, 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
E0036 EP Training and Testing Standard
G0682 Infection Prevention Standard
G0798 Home health aide assignments and duties 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
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
G0706 Interdisciplinary assessment of the patient Element
G0716 Preparing clinical notes Element
G0800 Services provided by HH aide Element
G1016 Goals in the patient's plans of care 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) 05/05/2022 389D7-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
G0510 Comprehensive Assessment of Patients Condition
G0570 Care planning, coordination, quality of care Condition
G0640 Quality assessment/performance improvement Condition
G0700 Skilled professional services Condition
E0006 Plan Based on All Hazards Risk Assessment Standard
E0030 Names and Contact Information Standard
E0037 EP Training Program Standard
E0039 EP Testing Requirements Standard
G0572 Plan of care Standard
G0578 Conformance with physician orders Standard
G0642 Program scope Standard
G0644 Program data Standard
G0658 Performance improvement projects Standard
G0660 Executive responsibilities for QAPI Standard
G0684 Infection control Standard
G0704 Responsibilities of skilled professionals Standard
G0798 Home health aide assignments and duties Standard
G0434 Participate in care Element
G0442 Written notice for non-covered care Element
G0484 Document complaint and resolution Element
G0514 RN performs assessment 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
G0574 Plan of care must include the following Element
G0590 Promptly alert relevant physician of changes Element
G0616 Patient medication schedule/instructions Element
G0710 Provide services in the plan of care Element
G0714 Patient and caregiver education 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) 05/23/2019 QJ2J11 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
G0446 Contact info Federal/State-funded entities Element
G0528 Health, psychosocial, functional, cognition Element
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0716 Preparing clinical notes Element
G0800 Services provided by HH aide Element
G0962 Coordinate patient care Element
G1022 Discharge and transfer summaries Element
▼ 239278 Holy Name Home Care, Inc 30700 Telegraph Rd, Suite 2560-B Bingham Farms MI 5 (Chicago) 03/01/2023 5F1AA-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
G0680 Infection prevention and control Condition
G0940 Organization and administration of services Condition
G1050 Personnel qualifications 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
E0036 EP Training and Testing Standard
E0039 EP Testing Requirements Standard
G0642 Program scope Standard
G0644 Program data 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
G0942 Governing body Standard
G1052 Administrator Standard
G0414 HHA administrator contact information Element
G0450 Access to auxiliary aids and language service Element
G0954 Ensures qualified pre-designated person Element
▼ 239279 American Home Health Care, Llc 2075 Fort Street, Suite 201 Lincoln Park MI 5 (Chicago) 04/21/2022 388CF-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0982 Skilled services furnished Standard
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
G1022 Discharge and transfer summaries Element
▼ 239279 American Home Health Care, Llc 2075 Fort Street, Suite 201 Lincoln Park MI 5 (Chicago) 05/09/2019 MVVC11 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
G0726 Nursing services supervised by RN Element
G1012 Required items in clinical record Element
▼ 239282 Clm Enterprises, Inc 1971 E Beltline Ave Ne, Suite 225 Grand Rapids MI 5 (Chicago) 04/06/2022 387A4-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0570 Care planning, coordination, quality of care Condition
G0578 Conformance with physician orders Standard
G0590 Promptly alert relevant physician of changes Element
G1012 Required items in clinical record Element
▼ 239283 Good Hope Home Health Services, Inc 3200 Cabaret Trl S Saginaw MI 5 (Chicago) 04/05/2019 8L5C11 Recertification, Sample Validation
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0424 Exercise of rights Standard
G0982 Skilled services furnished Standard
G0442 Written notice for non-covered care Element
G0534 Patient's needs Element
G0574 Plan of care must include the following Element
G0706 Interdisciplinary assessment of the patient Element
G1022 Discharge and transfer summaries Element
▼ 239284 American Nursing Home Health Care, Inc 6049 19 Mile Rd Sterling Heights MI 5 (Chicago) 01/27/2023 5EC3F-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0560 Discharge Planning Condition
G0570 Care planning, coordination, quality of care Condition
G0680 Infection prevention and control Condition
G0940 Organization and administration of services Condition
G1008 Clinical records Condition
E0017 HHA Comprehensive Assessment in Disaster Standard
E0037 EP Training Program Standard
G0562 Discharge Planning Standard
G0564 Discharge or Transfer Summary Content Standard
G0572 Plan of care 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
G0862 Laboratory services/CLIA waivers Standard
G0982 Skilled services furnished Standard
G1010 Contents of clinical record Standard
G1024 Authentication Standard
G1028 Protection of records Standard
G0432 Make complaints to the HHA Element
G0434 Participate in care Element
G0440 Payment from federally funded programs Element
G0522 Eligibility for Medicare home health benefit Element
G0528 Health, psychosocial, functional, cognition Element
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0584 Verbal orders Element
G0710 Provide services in the plan of care Element
G0948 Responsible for all day-to-day operations Element
G0956 Available during all operating hours Element
G1012 Required items in clinical record Element
▼ 239284 American Nursing Home Health Care, Inc 6049 19 Mile Rd Sterling Heights MI 5 (Chicago) 02/27/2020 4M7711 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0001 Establishment of the Emergency Program (EP) Condition
G0406 Patient rights 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
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
E0006 Plan Based on All Hazards Risk Assessment Standard
E0007 EP Program Patient Population Standard
E0009 Local, State, Tribal Collaboration Process Standard
E0013 Development of EP Policies and Procedures Standard
E0017 HHA Comprehensive Assessment in Disaster Standard
E0019 Homebound HHA/Hospice Inform EP Officials Standard
E0021 HHA- Procedures for Follow up Staff/Pts. Standard
E0023 Policies/Procedures for Medical Documentation Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0029 Development of Communication Plan Standard
E0030 Names and Contact Information Standard
E0031 Emergency Officials Contact Information Standard
E0032 Primary/Alternate Means for Communication Standard
E0033 Methods for Sharing Information Standard
E0034 Information on Occupancy/Needs Standard
E0036 EP Training and Testing Standard
E0037 EP Training Program Standard
E0039 EP Testing Requirements 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
G0684 Infection control Standard
G0686 Infection control education Standard
G0942 Governing body Standard
G0982 Skilled services furnished Standard
G1026 Retention of records Standard
G1028 Protection of records Standard
G1030 Retrieval of records Standard
G0414 HHA administrator contact information Element
G0432 Make complaints to the HHA Element
G0434 Participate in care Element
G0440 Payment from federally funded programs Element
G0446 Contact info Federal/State-funded entities 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
G0580 Only as ordered by a physician Element
G0620 Other pertinent instructions Element
G0622 Name/contact information of clinical manager Element
G0648 High risk, high volume, or problem-prone area Element
G0650 Incidence, prevalence, severity of problems Element
G0652 Activities lead to an immediate correction Element
G0656 Improvements are sustained Element
G0708 Development and evaluation of plan of care Element
G0710 Provide services in the plan of care Element
G0716 Preparing clinical notes Element
G0946 Administrator appointed by governing body Element
G0954 Ensures qualified pre-designated person Element
G0960 Make patient and personnel assignments, Element
G0962 Coordinate patient care Element
G0964 Coordinate referrals; Element
G1012 Required items in clinical record Element
G1022 Discharge and transfer summaries Element