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
▼ 248109 Benedictine Health Center Duluth 935 Kenwood Avenue Duluth MN 5 (Chicago) 07/25/2019 MCSF11 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
E0024 Policies/Procedures-Volunteers and Staffing Standard
▼ 248110 Benedictine Home Health 615 North First Street Cold Spring MN 5 (Chicago) 10/16/2024 64232-H1 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
G0808 Onsite supervisory visit every 14 days Element
▼ 248113 Alliance Hhc & Nursing Service 10405 6th Ave N, Ste 105 Plymouth MN 5 (Chicago) 04/08/2026 1F369B-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
G0774 12 hours inservice every 12 months Standard
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
G0588 Reviewed, revised by physician every 60 days Element
▼ 248113 Alliance Hhc & Nursing Service 10405 6th Ave N, Ste 105 Plymouth MN 5 (Chicago) 10/11/2024 64678-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0488 Immediate reporting of abuse by all staff Element
▼ 248113 Alliance Hhc & Nursing Service 10405 6th Ave N, Ste 105 Plymouth MN 5 (Chicago) 06/28/2023 5FCB9-H1 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
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0032 Primary/Alternate Means for Communication Standard
G0580 Only as ordered by a physician Element
▼ 248113 Alliance Hhc & Nursing Service 10405 6th Ave N, Ste 105 Plymouth MN 5 (Chicago) 05/31/2019 PMLF11 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
G0572 Plan of care Standard
G0422 Written notice within 4 business days Element
G0434 Participate in care Element
G0440 Payment from federally funded programs Element
G0514 RN performs assessment Element
G0536 A review of all current medications Element
G0548 Within 48 hours of the patient's return Element
G0550 At discharge Element
G0574 Plan of care must include the following Element
G0606 Integrate all services Element
G0720 Participate in the HHA's QAPI program; Element
G0722 Participate in HHA-sponsored in-service Element
G0754 A qualified HH aide successfully completed: Element
G0814 Non-skilled direct observation every 60 days Element
▼ 248113 Alliance Hhc & Nursing Service 10405 6th Ave N, Ste 105 Plymouth MN 5 (Chicago) 02/22/2019 FP8611 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0406 Patient rights Condition
G0430 Be free from abuse Element
G0482 Mistreatment, neglect or abuse Element
G0488 Immediate reporting of abuse by all staff Element
▼ 248115 Omega Home Healthcare Llc 4651 Nichols Road, Ste 110 Eagan MN 5 (Chicago) 04/30/2025 659A2-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
G0514 RN performs assessment Element
G0588 Reviewed, revised by physician every 60 days Element
G0984 In accordance with current clinical practice Element
▼ 248115 Omega Home Healthcare Llc 4651 Nichols Road, Ste 110 Eagan MN 5 (Chicago) 03/22/2023 5F003-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0588 Reviewed, revised by physician every 60 days Element
▼ 248118 Lifespark Home Health 5320 W 23rd St Suite 130 Saint Louis Park MN 5 (Chicago) 10/31/2024 648D0-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0580 Only as ordered by a physician Element