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
▼ 248082 Spot Rehabilitation Inc 2835 West Saint Germain St, Suite 300 Saint Cloud MN 5 (Chicago) 02/08/2024 61F30-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
G0374 Accuracy of encoded OASIS data Standard
G0578 Conformance with physician orders Standard
G0468 Provide contact info other services Element
G0514 RN performs assessment Element
G0536 A review of all current medications Element
G0580 Only as ordered by a physician Element
▼ 248085 Nightingale Home Health Care Of Minnesota,Inc. 10550 Wayzata Boulevard Suite 1 Minnetonka MN 5 (Chicago) 03/23/2021 LWTJ11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0488 Immediate reporting of abuse by all staff Element
G0710 Provide services in the plan of care Element
▼ 248086 The Evangelical Lutheran Good Samaritan Society 4080 W Broadway Ste 132 Robbinsdale MN 5 (Chicago) 08/20/2025 1D0CF1-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
G0468 Provide contact info other services Element
G0514 RN performs assessment Element
G0536 A review of all current medications Element
G0580 Only as ordered by a physician Element
▼ 248086 The Evangelical Lutheran Good Samaritan Society 4080 W Broadway Ste 132 Robbinsdale MN 5 (Chicago) 04/05/2023 5F46B-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
G0580 Only as ordered by a physician Element
▼ 248086 The Evangelical Lutheran Good Samaritan Society 4080 W Broadway Ste 132 Robbinsdale MN 5 (Chicago) 03/03/2022 3852C-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0406 Patient rights Condition
G0482 Mistreatment, neglect or abuse Element
G0488 Immediate reporting of abuse by all staff Element
▼ 248087 Medical Professionals, Llc 93 Little Canada Road W, Ste 312 Little Canada MN 5 (Chicago) 04/03/2024 623E2-H1 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
E0013 Development of EP Policies and Procedures Standard
E0029 Development of Communication Plan Standard
E0036 EP Training and Testing Standard
▼ 248087 Medical Professionals, Llc 93 Little Canada Road W, Ste 312 Little Canada MN 5 (Chicago) 03/15/2021 IV2511 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0570 Care planning, coordination, quality of care Condition
G0590 Promptly alert relevant physician of changes Element
G0710 Provide services in the plan of care Element
▼ 248087 Medical Professionals, Llc 93 Little Canada Road W, Ste 312 Little Canada MN 5 (Chicago) 02/13/2020 SVVP11 Complaint, Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0033 Methods for Sharing Information Standard
G0798 Home health aide assignments and duties Standard
G0580 Only as ordered by a physician Element
G0808 Onsite supervisory visit every 14 days Element
▼ 248088 Our Lady Of Peace 2076 St Anthony Avenue Saint Paul MN 5 (Chicago) 03/05/2026 1E40C7-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
▼ 248089 Summit Home Health Care Inc 800 Boone Avenue North Suite 175 Golden Valley MN 5 (Chicago) 03/27/2024 627F8-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
E0006 Plan Based on All Hazards Risk Assessment Standard
E0009 Local, State, Tribal Collaboration Process Standard
E0021 HHA- Procedures for Follow up Staff/Pts. Standard
E0034 Information on Occupancy/Needs Standard
E0039 EP Testing Requirements Standard
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element