S&C QCOR HHA 2567s
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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
▼ 247096 White Earth Band Of Chippewa 26246 Crane Road White Earth MN 5 (Chicago) 05/01/2024 62E76-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0462 Before discharge for cause HHA must: Element
G0464 Advise the patient of discharge for cause Element
G0478 Investigate complaints made by patient Element
▼ 247096 White Earth Band Of Chippewa 26246 Crane Road White Earth MN 5 (Chicago) 03/13/2024 623DF-H1 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
▼ 247096 White Earth Band Of Chippewa 26246 Crane Road White Earth MN 5 (Chicago) 02/14/2020 DWR611 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
E0037 EP Training Program Standard
G0374 Accuracy of encoded OASIS data Standard
G0574 Plan of care must include the following Element
G0590 Promptly alert relevant physician of changes Element
▼ 247103 Kittson Memorial Hospital Association 1010 South Birch Avenue Hallock MN 5 (Chicago) 05/30/2024 62418-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
▼ 247104 Interim Healthcare Of The Twin Cities 2680 Arthur Street Roseville MN 5 (Chicago) 01/24/2024 61B7E-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0514 RN performs assessment Element
▼ 247104 Interim Healthcare Of The Twin Cities 2680 Arthur Street Roseville MN 5 (Chicago) 02/01/2023 5EDA6-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0430 Be free from abuse Element
▼ 247104 Interim Healthcare Of The Twin Cities 2680 Arthur Street Roseville MN 5 (Chicago) 09/04/2019 MRZ811 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0704 Responsibilities of skilled professionals Standard
▼ 247111 Madison Healthcare Services 900 Second Avenue Madison MN 5 (Chicago) 07/26/2023 60158-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
G0574 Plan of care must include the following Element
G0802 Duties of a HH aide Element
▼ 247111 Madison Healthcare Services 900 Second Avenue Madison MN 5 (Chicago) 06/27/2018 TJ6H11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0574 Plan of care must include the following Element
▼ 247113 All Homecaring Minnesota Inc 4200 Central Avenue Ne Columbia Heights MN 5 (Chicago) 11/09/2023 613F0-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
E0006 Plan Based on All Hazards Risk Assessment Standard
E0009 Local, State, Tribal Collaboration Process Standard
E0013 Development of EP Policies and Procedures Standard
E0030 Names and Contact Information Standard
G0572 Plan of care Standard
G0516 Skilled professional performs assessment Element
G0574 Plan of care must include the following Element
G0576 All orders recorded in plan of care Element
G0588 Reviewed, revised by physician every 60 days Element