S&C QCOR HHA 2567s
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HHAs 2567s
Selection Criteria ▸

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
▼ 247137 Country Manor Extended Services 520 First Street Northeast Sartell MN 5 (Chicago) 10/25/2023 6107B-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0520 5 calendar days after start of care Element
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
▼ 247137 Country Manor Extended Services 520 First Street Northeast Sartell MN 5 (Chicago) 10/03/2019 CZSQ11 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
G0682 Infection Prevention Standard
G0434 Participate in care Element
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0808 Onsite supervisory visit every 14 days Element
G0814 Non-skilled direct observation every 60 days Element
▼ 247138 Northfield Home Care 1604 Riverview Drive Northfield MN 5 (Chicago) 10/26/2023 6154A-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0478 Investigate complaints made by patient Element
G0488 Immediate reporting of abuse by all staff Element
▼ 247138 Northfield Home Care 1604 Riverview Drive Northfield MN 5 (Chicago) 04/12/2023 5F46E-H1 Complaint, Focused Infection Control, 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
▼ 247138 Northfield Home Care 1604 Riverview Drive Northfield MN 5 (Chicago) 02/03/2021 HM3N11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0488 Immediate reporting of abuse by all staff Element
▼ 247145 Centerwell Certified Healthcare Corp 7101 Northland Circle, Ste 101 Brooklyn Park MN 5 (Chicago) 03/26/2025 655C7-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
G0602 Communication with all physicians Element
G0710 Provide services in the plan of care Element
▼ 247145 Centerwell Certified Healthcare Corp 7101 Northland Circle, Ste 101 Brooklyn Park MN 5 (Chicago) 10/16/2024 646F9-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0514 RN performs assessment Element
▼ 247151 Park Nicollet Methodist Hospital Care Svcs 4916 Excelsior Blvd Minneapolis MN 5 (Chicago) 01/04/2019 VH8Q11 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
G0590 Promptly alert relevant physician of changes Element
▼ 247152 Clarkfield Home Health Agency 1012 12th Avenue Clarkfield MN 5 (Chicago) 06/28/2023 5FC40-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
E0007 EP Program Patient Population Standard
E0036 EP Training and Testing Standard
G0862 Laboratory services/CLIA waivers Standard
▼ 247156 Sacred Heart Home Health Care 1200 12th Street Southwest Austin MN 5 (Chicago) 07/18/2019 9CVL11 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
G0488 Immediate reporting of abuse by all staff Element
G0536 A review of all current medications Element
G0582 Influenza and pneumococcal vaccines Element
G0588 Reviewed, revised by physician every 60 days Element
G0722 Participate in HHA-sponsored in-service Element
G0802 Duties of a HH aide Element