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
▼ 247215 Sanford Bemidji Home Care And Hospice 3201 Pine Ridge Ave Nw Ste A Bemidji MN 5 (Chicago) 01/30/2020 423S11 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
▼ 247216 Chippewa County Montevideo Hospital Home Care 1409 Mn - 7 Montevideo MN 5 (Chicago) 01/08/2026 1DE002-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
▼ 247216 Chippewa County Montevideo Hospital Home Care 1409 Mn - 7 Montevideo MN 5 (Chicago) 10/24/2018 WOJ811 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
▼ 247217 Ecumen Home Care And Hospice - Litchfield 218 North Holcombe Avenue Litchfield MN 5 (Chicago) 11/13/2020 9I8Q11 Complaint, 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
G0682 Infection Prevention Standard
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
▼ 247218 Recover Health Of Minnesota, Inc. 820 9th Street North, Suite 140 Virginia MN 5 (Chicago) 10/20/2022 5DCE6-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0452 Transfer and discharge Standard
G0578 Conformance with physician orders Standard
G0434 Participate in care Element
G0488 Immediate reporting of abuse by all staff Element
G0536 A review of all current medications Element
G0708 Development and evaluation of plan of care Element
▼ 247218 Recover Health Of Minnesota, Inc. 820 9th Street North, Suite 140 Virginia MN 5 (Chicago) 04/25/2019 XVFG11 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
G0434 Participate in care Element
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0814 Non-skilled direct observation every 60 days Element
▼ 247219 Care Plus Home Health Agency Inc 1299 Arcade Street Ste 100 Saint Paul MN 5 (Chicago) 04/23/2025 659A0-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
G0862 Laboratory services/CLIA waivers Standard
G0514 RN performs assessment Element
G0580 Only as ordered by a physician Element
▼ 247219 Care Plus Home Health Agency Inc 1299 Arcade Street Ste 100 Saint Paul MN 5 (Chicago) 03/02/2023 5F0AF-H1 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
E0004 Develop EP Plan, Review and Update Annually Standard
E0007 EP Program Patient Population Standard
E0023 Policies/Procedures for Medical Documentation Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0031 Emergency Officials Contact Information Standard
E0039 EP Testing Requirements Standard
G0684 Infection control Standard
G0687 COVID-19 Vaccination of Home Health Agency staff Standard
G0862 Laboratory services/CLIA waivers Standard
G0480 Treatment or care Element
G0514 RN performs assessment Element
G0536 A review of all current medications Element
G0576 All orders recorded in plan of care Element
G0580 Only as ordered by a physician Element
G0590 Promptly alert relevant physician of changes Element
G0604 Integrate all orders Element
▼ 247219 Care Plus Home Health Agency Inc 1299 Arcade Street Ste 100 Saint Paul MN 5 (Chicago) 06/04/2020 D0DV11 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
E0024 Policies/Procedures-Volunteers and Staffing Standard
G0682 Infection Prevention Standard
▼ 247219 Care Plus Home Health Agency Inc 1299 Arcade Street Ste 100 Saint Paul MN 5 (Chicago) 01/04/2018 C6VL11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0158 ACCEPTANCE OF PATIENTS, POC, MED SUPER Standard
G0159 PLAN OF CARE Standard
G0229 SUPERVISION Standard
G0324 TRANSMITTAL OF OASIS DATA Standard
G0337 DRUG REGIMEN REVIEW Standard