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
▼ 247171 Cuyuna Reg Medical Ctr Homehealth, Palliative & Hospice Care 500 Heartwood Drive Crosby MN 5 (Chicago) 06/11/2021 N8JS11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0023 Policies/Procedures for Medical Documentation Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
G0434 Participate in care 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
▼ 247172 Ely Bloomenson Hospital Hha 328 West Conan Street Ely MN 5 (Chicago) 07/26/2018 XMZS11 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
▼ 247177 Integrated Home Care 475 Etna Street, Suite 3 Saint Paul MN 5 (Chicago) 08/23/2018 1Y3911 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
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
E0033 Methods for Sharing Information Standard
E0034 Information on Occupancy/Needs Standard
E0037 EP Training Program Standard
G0572 Plan of care Standard
G0754 A qualified HH aide successfully completed: Element
▼ 247180 Volunteers Of America Home Health Of Southeastern Minnesota 1800 High Pointe Lane Nw, Suite 250 Rochester MN 5 (Chicago) 04/23/2025 65C41-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
G0572 Plan of care Standard
G0514 RN performs assessment Element
G1022 Discharge and transfer summaries Element
▼ 247185 Recover Health Of Minnesota, Inc 60 10th Avenue South #60 Waite Park MN 5 (Chicago) 10/22/2021 19754-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0682 Infection Prevention Standard
G0536 A review of all current medications Element
▼ 247185 Recover Health Of Minnesota, Inc 60 10th Avenue South #60 Waite Park MN 5 (Chicago) 05/25/2021 TQWK11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0486 Protect patient during investigation Element
G0488 Immediate reporting of abuse by all staff Element
▼ 247194 Mille Lacs Home Care 200 Elm Street North Onamia MN 5 (Chicago) 09/29/2022 4F3DB-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
G0462 Before discharge for cause HHA must: Element
G0514 RN performs assessment Element
G0536 A review of all current medications Element
▼ 247194 Mille Lacs Home Care 200 Elm Street North Onamia MN 5 (Chicago) 07/17/2020 8SFV11 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
G0680 Infection prevention and control Condition
G0682 Infection Prevention Standard
▼ 247196 Lutheran Brethren Home Health Services, Inc 824 South Sheridan Street Fergus Falls MN 5 (Chicago) 10/17/2019 XSYW11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0430 Be free from abuse Element
G0434 Participate in care Element
▼ 247202 Madelia Community Hospital Home Care 121 Drew Avenue Southeast Madelia MN 5 (Chicago) 12/07/2022 5E5D8-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
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
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
E0042 Integrated EP Program Standard
G0724 Supervise skilled professional assistants Standard
G0718 Communication with physicians Element