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
▼ 267191 Adair County Health Department/Home Health Agency 1001 South Jamison Street Kirksville MO 7 (Kansas City) 12/07/2022 5E778-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
E0037 EP Training Program Standard
G0686 Infection control education Standard
G0514 RN performs assessment Element
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0580 Only as ordered by a physician Element
G0588 Reviewed, revised by physician every 60 days Element
G0590 Promptly alert relevant physician of changes Element
G0722 Participate in HHA-sponsored in-service Element
G0984 In accordance with current clinical practice Element
▼ 267191 Adair County Health Department/Home Health Agency 1001 South Jamison Street Kirksville MO 7 (Kansas City) 12/19/2019 PSLN11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0580 Only as ordered by a physician Element
G0616 Patient medication schedule/instructions Element
G0622 Name/contact information of clinical manager Element
▼ 267195 Saint Luke's Health System Home Care And Hospice 903 East 104th St Kansas City MO 7 (Kansas City) 06/25/2024 637AE-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
G0574 Plan of care must include the following Element
▼ 267195 Saint Luke's Health System Home Care And Hospice 903 East 104th St Kansas City MO 7 (Kansas City) 11/18/2021 37F64-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0510 Comprehensive Assessment of Patients Condition
G0572 Plan of care Standard
G0682 Infection Prevention Standard
G0702 Services by skilled professionals Standard
G0444 State toll free HH telephone hotline Element
G0446 Contact info Federal/State-funded entities Element
G0528 Health, psychosocial, functional, cognition Element
G0536 A review of all current medications Element
G0614 Visit schedule Element
G0620 Other pertinent instructions Element
G0622 Name/contact information of clinical manager Element
G0788 Org. had partial/extended survey Element
▼ 267195 Saint Luke's Health System Home Care And Hospice 903 East 104th St Kansas City MO 7 (Kansas City) 12/19/2018 H55L11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0798 Home health aide assignments and duties Standard
G0528 Health, psychosocial, functional, cognition Element
G0536 A review of all current medications Element
G0706 Interdisciplinary assessment of the patient Element
G0710 Provide services in the plan of care Element
G0800 Services provided by HH aide Element
G0804 Aides are members of interdisciplinary team Element
G0984 In accordance with current clinical practice Element
▼ 267195 Saint Luke's Health System Home Care And Hospice 903 East 104th St Kansas City MO 7 (Kansas City) 12/04/2018 25VM11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0570 Care planning, coordination, quality of care Condition
G0682 Infection Prevention Standard
G0484 Document complaint and resolution Element
G0486 Protect patient during investigation Element
G0574 Plan of care must include the following Element
G0580 Only as ordered by a physician Element
G0614 Visit schedule Element
G0616 Patient medication schedule/instructions Element
G0618 Treatments and therapy services Element
▼ 267196 Citizens Memorial Home Health And Hospice 111 W Broadway Bolivar MO 7 (Kansas City) 11/01/2023 61690-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G1024 Authentication Standard
G0422 Written notice within 4 business days Element
G0536 A review of all current medications Element
G0590 Promptly alert relevant physician of changes Element
G0616 Patient medication schedule/instructions Element
G0706 Interdisciplinary assessment of the patient Element
G1022 Discharge and transfer summaries Element
▼ 267196 Citizens Memorial Home Health And Hospice 111 W Broadway Bolivar MO 7 (Kansas City) 01/25/2021 HRMO11 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
G0798 Home health aide assignments and duties Standard
G0536 A review of all current medications Element
G0706 Interdisciplinary assessment of the patient Element
▼ 267206 Carroll County Memorial Hospital 1502 N Jefferson Street Carrollton MO 7 (Kansas City) 11/03/2021 37E27-H1 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
G0440 Payment from federally funded programs Element
G0444 State toll free HH telephone hotline Element
G0536 A review of all current medications Element
G0614 Visit schedule Element
G1022 Discharge and transfer summaries Element
▼ 267206 Carroll County Memorial Hospital 1502 N Jefferson Street Carrollton MO 7 (Kansas City) 11/28/2018 K9ID11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0644 Program data Standard
G0798 Home health aide assignments and duties Standard
G0574 Plan of care must include the following Element
G0584 Verbal orders Element
G0722 Participate in HHA-sponsored in-service Element