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
▼ 247113 All Homecaring Minnesota Inc 4200 Central Avenue Ne Columbia Heights MN 5 (Chicago) 05/19/2021 5LQM11 Complaint, Focused Infection Control, Other-Fed
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0406 Patient rights Condition
G0510 Comprehensive Assessment of Patients Condition
G0750 Home health aide services Condition
G0430 Be free from abuse Element
G0488 Immediate reporting of abuse by all staff Element
G0546 Last 5 days of every 60 days unless: Element
G0814 Non-skilled direct observation every 60 days Element
▼ 247113 All Homecaring Minnesota Inc 4200 Central Avenue Ne Columbia Heights MN 5 (Chicago) 05/28/2020 MSHO11 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
▼ 247113 All Homecaring Minnesota Inc 4200 Central Avenue Ne Columbia Heights MN 5 (Chicago) 12/26/2019 WZ1K11 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
G0512 Standard: Initial assessment visit. Standard
G0578 Conformance with physician orders Standard
G0514 RN performs assessment Element
G0574 Plan of care must include the following Element
G0656 Improvements are sustained Element
▼ 247117 St. Cloud Hospital 110 2nd Street South Ste 104 Waite Park MN 5 (Chicago) 02/25/2026 1E3711-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
G0574 Plan of care must include the following Element
▼ 247117 St. Cloud Hospital 110 2nd Street South Ste 104 Waite Park MN 5 (Chicago) 03/21/2019 LJC311 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
▼ 247120 Avera Granite Falls Home Health 500 Skyview Drive Granite Falls MN 5 (Chicago) 04/26/2018 I97511 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0808 Onsite supervisory visit every 14 days Element
▼ 247124 Lakewood Health System 401 East Prairie Avenue Ne Staples MN 5 (Chicago) 06/25/2021 WS2C11 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
G0434 Participate in care Element
G0536 A review of all current medications Element
G0714 Patient and caregiver education Element
▼ 247126 Kanabec County 905 East Forest Avenue Suite 127 Mora MN 5 (Chicago) 12/18/2020 HQE311 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
G0510 Comprehensive Assessment of Patients Condition
G0526 Content of the comprehensive assessment Standard
G0572 Plan of care Standard
G0440 Payment from federally funded programs Element
G0514 RN performs assessment Element
G0546 Last 5 days of every 60 days unless: Element
G0574 Plan of care must include the following Element
G0808 Onsite supervisory visit every 14 days Element
▼ 247133 Kwo 5 Star Inc 22 Central Ave Se Po Box 414 New London MN 5 (Chicago) 11/18/2020 X6QD11 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
▼ 247133 Kwo 5 Star Inc 22 Central Ave Se Po Box 414 New London MN 5 (Chicago) 02/09/2018 L75A11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0179 DUTIES OF THE LICENSED PRACTICAL NURSE Standard