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
▼ 247049 Pipestone County Home Health Agency 916 4th Avenue Sw Pipestone MN 5 (Chicago) 12/19/2019 DAIY11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0013 Development of EP Policies and Procedures Standard
E0029 Development of Communication Plan Standard
G0574 Plan of care must include the following Element
G0582 Influenza and pneumococcal vaccines Element
▼ 247055 Pennington & Red Lake County Public Health & Home Care 101 Main Avenue North Thief River Falls MN 5 (Chicago) 06/11/2025 6624B-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0372 Encoding and transmitting OASIS Standard
G1022 Discharge and transfer summaries Element
▼ 247055 Pennington & Red Lake County Public Health & Home Care 101 Main Avenue North Thief River Falls MN 5 (Chicago) 04/19/2023 5F4E2-H1 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
▼ 247055 Pennington & Red Lake County Public Health & Home Care 101 Main Avenue North Thief River Falls MN 5 (Chicago) 12/13/2019 FTD411 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0006 Plan Based on All Hazards Risk Assessment Standard
G0536 A review of all current medications Element
▼ 247056 Le Sueur County Public Health 130 South Park Avenue Le Center MN 5 (Chicago) 10/16/2019 Y6HJ11 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
▼ 247061 Todd County Phns 212 2nd Avenue South Long Prairie MN 5 (Chicago) 06/02/2022 4EB80-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0687 COVID-19 Vaccination of Home Health Agency staff Standard
▼ 247061 Todd County Phns 212 2nd Avenue South Long Prairie MN 5 (Chicago) 07/24/2019 32CG11 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
▼ 247071 Caring Hands Home Care Inc 113 Minnesota Avenue West Sebeka MN 5 (Chicago) 04/23/2025 6597D-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
G0372 Encoding and transmitting OASIS Standard
G0514 RN performs assessment Element
▼ 247071 Caring Hands Home Care Inc 113 Minnesota Avenue West Sebeka MN 5 (Chicago) 03/29/2023 5F01A-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
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0030 Names and Contact Information Standard
E0031 Emergency Officials Contact Information Standard
E0039 EP Testing Requirements Standard
G0578 Conformance with physician orders Standard
G0646 Program activities Standard
G0684 Infection control Standard
G0687 COVID-19 Vaccination of Home Health Agency staff Standard
G0528 Health, psychosocial, functional, cognition Element
G0536 A review of all current medications Element
G1022 Discharge and transfer summaries Element
▼ 247078 Accentcare Fairview Home Health - West, Llc 767 Eustis Street, Suite 150 Saint Paul MN 5 (Chicago) 08/13/2025 1D0E87-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
G0372 Encoding and transmitting OASIS Standard