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
▼ 267161 Excelsior Springs City Hospital 1010 N Jesse James Rd Excelsior Springs MO 7 (Kansas City) 12/16/2021 3810D-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
G0440 Payment from federally funded programs Element
G0444 State toll free HH telephone hotline Element
G0536 A review of all current medications Element
G0580 Only as ordered by a physician Element
G0590 Promptly alert relevant physician of changes Element
G0614 Visit schedule Element
G0616 Patient medication schedule/instructions Element
G1022 Discharge and transfer summaries Element
▼ 267161 Excelsior Springs City Hospital 1010 N Jesse James Rd Excelsior Springs MO 7 (Kansas City) 01/09/2019 7UVD11 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
G0798 Home health aide assignments and duties Standard
G0536 A review of all current medications Element
G0538 Primary caregiver(s), if any Element
G0574 Plan of care must include the following Element
G0706 Interdisciplinary assessment of the patient Element
G0710 Provide services in the plan of care Element
G0800 Services provided by HH aide Element
G0818 HH aide supervision elements Element
▼ 267163 Southeast Health Center Of Stoddard County, Llc 1300 N One Mile Road - Suite 7 Dexter MO 7 (Kansas City) 07/22/2021 59KW11 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
G0446 Contact info Federal/State-funded entities Element
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0614 Visit schedule Element
G0710 Provide services in the plan of care Element
G0954 Ensures qualified pre-designated person Element
G0984 In accordance with current clinical practice Element
G1022 Discharge and transfer summaries Element
▼ 267168 F.C. Of Missouri, Inc 4305 South National Avenue Springfield MO 7 (Kansas City) 02/28/2018 VZZ611 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0984 In accordance with current clinical practice Element
▼ 267182 Novus Lifecare Home Health Of Clinton, Llc 136 S Main Street Clinton MO 7 (Kansas City) 06/03/2026 234AF2-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0490 Accessibility Standard
G0572 Plan of care Standard
G0450 Access to auxiliary aids and language service Element
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0984 In accordance with current clinical practice Element
G1022 Discharge and transfer summaries Element
▼ 267182 Novus Lifecare Home Health Of Clinton, Llc 136 S Main Street Clinton MO 7 (Kansas City) 05/27/2021 MI6311 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
G0570 Care planning, coordination, quality of care Condition
G0682 Infection Prevention Standard
G0414 HHA administrator contact information Element
G0422 Written notice within 4 business days Element
G0440 Payment from federally funded programs Element
G0446 Contact info Federal/State-funded entities Element
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0590 Promptly alert relevant physician of changes Element
G0592 Revised plan of care Element
G0608 Coordinate care delivery Element
G0614 Visit schedule Element
G0618 Treatments and therapy services Element
G0622 Name/contact information of clinical manager Element
G0706 Interdisciplinary assessment of the patient Element
G0788 Org. had partial/extended survey Element
G1022 Discharge and transfer summaries Element
▼ 267182 Novus Lifecare Home Health Of Clinton, Llc 136 S Main Street Clinton MO 7 (Kansas City) 04/12/2018 E7GN11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0420 [Removed and Reserved] Element
G0446 Contact info Federal/State-funded entities Element
G0488 Immediate reporting of abuse by all staff Element
G0536 A review of all current medications Element
G0580 Only as ordered by a physician Element
▼ 267184 Ssm Health Businesses 12800 Corporate Hill Saint Louis MO 7 (Kansas City) 12/13/2023 61B4A-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
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0614 Visit schedule Element
G0618 Treatments and therapy services Element
▼ 267184 Ssm Health Businesses 12800 Corporate Hill Saint Louis MO 7 (Kansas City) 05/24/2022 4EBBC-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0687 COVID-19 Vaccination of Home Health Agency staff Standard
G0590 Promptly alert relevant physician of changes Element
▼ 267184 Ssm Health Businesses 12800 Corporate Hill Saint Louis MO 7 (Kansas City) 09/14/2021 OMXP11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0514 RN performs assessment Element