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
▼ 267223 Benton County Health Department Home Health Agency 1238 Commercial Street Warsaw MO 7 (Kansas City) 05/06/2026 2313E3-H1 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
▼ 267223 Benton County Health Department Home Health Agency 1238 Commercial Street Warsaw MO 7 (Kansas City) 05/17/2023 5FD70-H1 Focused Infection Control, Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
E0037 EP Training Program Standard
G0682 Infection Prevention Standard
G0686 Infection control education Standard
G0536 A review of all current medications Element
G0590 Promptly alert relevant physician of changes Element
G0710 Provide services in the plan of care Element
G0722 Participate in HHA-sponsored in-service Element
G0984 In accordance with current clinical practice Element
▼ 267223 Benton County Health Department Home Health Agency 1238 Commercial Street Warsaw MO 7 (Kansas City) 09/01/2020 BM0I11 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
G0514 RN performs assessment Element
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0576 All orders recorded in plan of care Element
G0714 Patient and caregiver education Element
G0800 Services provided by HH aide Element
▼ 267246 Salem Memorial District Hospital Home Health Agency 35629 Hwy 72 Salem MO 7 (Kansas City) 01/05/2023 5EA8D-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0476 Investigation of complaints Standard
G0682 Infection Prevention Standard
G0684 Infection control Standard
G1024 Authentication Standard
G0516 Skilled professional performs assessment Element
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0602 Communication with all physicians Element
G0954 Ensures qualified pre-designated person Element
▼ 267246 Salem Memorial District Hospital Home Health Agency 35629 Hwy 72 Salem MO 7 (Kansas City) 01/08/2020 CFD011 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
G0490 Accessibility Standard
G0446 Contact info Federal/State-funded entities Element
G0454 HHA can no longer meet the patient's needs Element
G0462 Before discharge for cause HHA must: Element
G0464 Advise the patient of discharge for cause Element
G0466 Make efforts to resolve the problem(s) Element
G0468 Provide contact info other services Element
G0470 Document efforts to resolve problems Element
G0530 Strengths, goals, and care preferences Element
G0574 Plan of care must include the following Element
G0614 Visit schedule Element
G0710 Provide services in the plan of care Element
G0984 In accordance with current clinical practice Element
G1022 Discharge and transfer summaries Element
▼ 267247 Perry County Health System 5 Circle Drive Perryville MO 7 (Kansas City) 05/19/2021 VK4Q11 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
G0446 Contact info Federal/State-funded entities Element
G0464 Advise the patient of discharge for cause Element
G0472 Death of patient Element
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
▼ 267247 Perry County Health System 5 Circle Drive Perryville MO 7 (Kansas City) 02/06/2018 WPL911 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
E0037 EP Training Program Standard
G1030 Retrieval of records Standard
G0430 Be free from abuse Element
G0536 A review of all current medications Element
G0984 In accordance with current clinical practice Element
▼ 267250 Benders Home Care Inc 803 North 36th Street Saint Joseph MO 7 (Kansas City) 07/15/2021 I6H911 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
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
▼ 267250 Benders Home Care Inc 803 North 36th Street Saint Joseph MO 7 (Kansas City) 08/09/2018 5VD611 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0410 Information to patient Element
G0574 Plan of care must include the following Element
G0604 Integrate all orders Element
G0710 Provide services in the plan of care Element
▼ 267253 Mercy Hospital South 9735 Landmark Parkway - Suite 201 Saint Louis MO 7 (Kansas City) 01/05/2023 5EAB5-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
G0702 Services by skilled professionals Standard
G1024 Authentication Standard
G0422 Written notice within 4 business days Element
G0574 Plan of care must include the following Element
G0590 Promptly alert relevant physician of changes Element