S&C QCOR HHA 2567s
d QCOR:  Quality, Certification and Oversight Reports.
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
248055 Divine Healthcare Corporation 856 University Avenue West Saint Paul MN 5 (Chicago) 11/15/2018 X38T11 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
E0004 Develop EP Plan, Review and Update Annually Standard
E0017 HHA Comprehensive Assessment in Disaster Standard
G0578 Conformance with physician orders Standard
G0484 Document complaint and resolution Element
248056 Adara Home Health Inc 25 1st Avenue Ne Ste 100 Buffalo MN 5 (Chicago) 01/16/2025 65166-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0602 Communication with all physicians Element
248056 Adara Home Health Inc 25 1st Avenue Ne Ste 100 Buffalo MN 5 (Chicago) 11/15/2024 646CC-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
G0372 Encoding and transmitting OASIS Standard
G0536 A review of all current medications Element
G0576 All orders recorded in plan of care Element
248056 Adara Home Health Inc 25 1st Avenue Ne Ste 100 Buffalo MN 5 (Chicago) 08/07/2024 63B8E-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0570 Care planning, coordination, quality of care Condition
G0572 Plan of care Standard
G0574 Plan of care must include the following Element
248056 Adara Home Health Inc 25 1st Avenue Ne Ste 100 Buffalo MN 5 (Chicago) 04/05/2024 62A8A-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0682 Infection Prevention Standard
G0576 All orders recorded in plan of care Element
G0580 Only as ordered by a physician Element
248056 Adara Home Health Inc 25 1st Avenue Ne Ste 100 Buffalo MN 5 (Chicago) 04/13/2023 5F7C5-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0510 Comprehensive Assessment of Patients Condition
G0478 Investigate complaints made by patient Element
G0536 A review of all current medications Element
248056 Adara Home Health Inc 25 1st Avenue Ne Ste 100 Buffalo MN 5 (Chicago) 03/23/2023 5F546-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0406 Patient rights Condition
G0510 Comprehensive Assessment of Patients Condition
G0578 Conformance with physician orders Standard
G0428 Property and person treated with respect Element
G0430 Be free from abuse Element
G0478 Investigate complaints made by patient Element
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0616 Patient medication schedule/instructions Element
G0620 Other pertinent instructions Element
G0706 Interdisciplinary assessment of the patient Element
248056 Adara Home Health Inc 25 1st Avenue Ne Ste 100 Buffalo MN 5 (Chicago) 08/19/2022 4F40E-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0716 Preparing clinical notes Element
248056 Adara Home Health Inc 25 1st Avenue Ne Ste 100 Buffalo MN 5 (Chicago) 04/21/2022 387BB-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
G0940 Organization and administration of services Condition
G0578 Conformance with physician orders Standard
G0684 Infection control Standard
G0536 A review of all current medications Element
G0580 Only as ordered by a physician Element
G0972 Report all branch locations to SA Element
G0974 Direct support and administrative control Element
248056 Adara Home Health Inc 25 1st Avenue Ne Ste 100 Buffalo MN 5 (Chicago) 05/10/2018 GMQK11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0814 Non-skilled direct observation every 60 days Element