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
▼ 277097 Clark Fork Healthcare Llc 205 Haggerty Ln Ste 260 Bozeman MT 8 (Denver) 04/02/2019 I31S11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0612 Written instructions to patient include: Standard
G0574 Plan of care must include the following Element
G0576 All orders recorded in plan of care Element
G0614 Visit schedule Element
G0710 Provide services in the plan of care Element
▼ 277098 Home Based Services Initiative Llc D/B/A St John's United Home Health 502 North 30th Street Billings MT 8 (Denver) 01/15/2026 1E0592-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
▼ 277301 Homestead Health Llc 208 B Drive Circle MT 8 (Denver) 02/25/2026 1E4AC6-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
G0640 Quality assessment/performance improvement Condition
G0680 Infection prevention and control Condition
G0940 Organization and administration of services Condition
E0004 Develop EP Plan, Review and Update Annually Standard
E0006 Plan Based on All Hazards Risk Assessment Standard
E0007 EP Program Patient Population Standard
E0009 Local, State, Tribal Collaboration Process Standard
E0013 Development of EP Policies and Procedures Standard
E0021 HHA- Procedures for Follow up Staff/Pts. Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0029 Development of Communication Plan Standard
E0030 Names and Contact Information Standard
E0031 Emergency Officials Contact Information Standard
E0032 Primary/Alternate Means for Communication Standard
E0033 Methods for Sharing Information Standard
E0036 EP Training and Testing Standard
E0037 EP Training Program Standard
E0039 EP Testing Requirements Standard
G0372 Encoding and transmitting OASIS Standard
G0642 Program scope Standard
G0644 Program data Standard
G0646 Program activities Standard
G0654 Track adverse patient events Standard
G0658 Performance improvement projects Standard
G0660 Executive responsibilities for QAPI Standard
G0682 Infection Prevention Standard
G0684 Infection control Standard
G0942 Governing body Standard
G0988 Institutional planning Standard
G0514 RN performs assessment Element
G0656 Improvements are sustained Element
G0954 Ensures qualified pre-designated person Element
▼ 277301 Homestead Health Llc 208 B Drive Circle MT 8 (Denver) 03/01/2023 5F160-H1 Initial Certification
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
G0682 Infection Prevention Standard
G0958 Clinical manager Standard
G0514 RN performs assessment Element
G0754 A qualified HH aide successfully completed: Element
▼ 277302 Home And Care Billings 1643 24th Street West Billings MT 8 (Denver) 06/18/2026 235B55-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
E0039 EP Testing Requirements Standard
G0372 Encoding and transmitting OASIS Standard
G0574 Plan of care must include the following Element
G0576 All orders recorded in plan of care Element
G0984 In accordance with current clinical practice Element
▼ 287002 Tabitha, Inc. 4720 Randolph Street Lincoln NE 7 (Kansas City) 07/25/2022 4F25E-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0700 Skilled professional services Condition
G0940 Organization and administration of services Condition
G0578 Conformance with physician orders Standard
G0706 Interdisciplinary assessment of the patient Element
G0710 Provide services in the plan of care Element
G0960 Make patient and personnel assignments, Element
G0966 Assure patient needs are continually assessed Element
G0968 Assure implementation of plan of care Element
▼ 287002 Tabitha, Inc. 4720 Randolph Street Lincoln NE 7 (Kansas City) 12/02/2021 38091-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0682 Infection Prevention Standard
G0798 Home health aide assignments and duties Standard
▼ 287002 Tabitha, Inc. 4720 Randolph Street Lincoln NE 7 (Kansas City) 11/14/2018 I3MX11 Complaint, 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
G0514 RN performs assessment Element
G0520 5 calendar days after start of care Element
G0520 5 calendar days after start of care Element
G0546 Last 5 days of every 60 days unless: Element
G0574 Plan of care must include the following Element
G0580 Only as ordered by a physician Element
G0590 Promptly alert relevant physician of changes Element
G0590 Promptly alert relevant physician of changes Element
G0804 Aides are members of interdisciplinary team Element
G0808 Onsite supervisory visit every 14 days Element
▼ 287003 Amedisys Home Health Of Nebraska, L.L.C. 10040 Regency Circle, Suite 125 Omaha NE 7 (Kansas City) 01/15/2025 651E2-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0682 Infection Prevention Standard
G0576 All orders recorded in plan of care Element
G0596 Revisions communicated to patient and MDs Element
▼ 287003 Amedisys Home Health Of Nebraska, L.L.C. 10040 Regency Circle, Suite 125 Omaha NE 7 (Kansas City) 02/02/2022 383AA-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0798 Home health aide assignments and duties Standard
G0984 In accordance with current clinical practice Element