S&C QCOR HHA 2567s
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HHAs 2567s
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Time Interval

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Provider Characteristics

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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
▼ 287139 Zutan Home Healthcare, Inc. 3909 Cuming Street, Suite 203 Omaha NE 7 (Kansas City) 05/25/2023 5FEE1-H1 Complaint, Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0592 Revised plan of care Element
▼ 287144 Progressive Home Health & Hospice Llc 3032 W Stolley Park Rd Grand Island NE 7 (Kansas City) 05/30/2024 6341A-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0682 Infection Prevention Standard
G0536 A review of all current medications Element
▼ 287144 Progressive Home Health & Hospice Llc 3032 W Stolley Park Rd Grand Island NE 7 (Kansas City) 12/17/2019 MVOC11 Complaint
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
G0510 Comprehensive Assessment of Patients Condition
G0570 Care planning, coordination, quality of care Condition
G0640 Quality assessment/performance improvement Condition
G0700 Skilled professional services Condition
G0750 Home health aide services Condition
G0848 Compliance with Federal, State, Local Law Condition
G0940 Organization and administration of services Condition
E0006 Plan Based on All Hazards Risk Assessment Standard
E0039 EP Testing Requirements Standard
G0544 Update of the comprehensive assessment Standard
G0572 Plan of care Standard
G0642 Program scope Standard
G0658 Performance improvement projects Standard
G0702 Services by skilled professionals Standard
G0768 Competency evaluation Standard
G0958 Clinical manager Standard
G0514 RN performs assessment Element
G0522 Eligibility for Medicare home health benefit Element
G0574 Plan of care must include the following Element
G0590 Promptly alert relevant physician of changes Element
G0592 Revised plan of care Element
G0606 Integrate all services Element
G0726 Nursing services supervised by RN Element
G0808 Onsite supervisory visit every 14 days Element
G0818 HH aide supervision elements Element
G0950 Ensure clinical manager is available Element
G0954 Ensures qualified pre-designated person Element
G0966 Assure patient needs are continually assessed Element
G1012 Required items in clinical record Element
G1022 Discharge and transfer summaries Element
▼ 287144 Progressive Home Health & Hospice Llc 3032 W Stolley Park Rd Grand Island NE 7 (Kansas City) 08/30/2018 XEBC11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0808 Onsite supervisory visit every 14 days Element
▼ 287144 Progressive Home Health & Hospice Llc 3032 W Stolley Park Rd Grand Island NE 7 (Kansas City) 03/19/2018 BWVX11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0948 Responsible for all day-to-day operations Element
G0950 Ensure clinical manager is available Element
▼ 287146 Fidelity Home Health Care, Llc 6550 South 84th, Suite 100 A Omaha NE 7 (Kansas City) 08/02/2018 G5T711 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
E0001 Establishment of the Emergency Program (EP) Condition
G0570 Care planning, coordination, quality of care Condition
G0640 Quality assessment/performance improvement Condition
G0750 Home health aide services Condition
G0940 Organization and administration of services Condition
E0006 Plan Based on All Hazards Risk Assessment Standard
E0037 EP Training Program Standard
E0039 EP Testing Requirements Standard
G0572 Plan of care Standard
G0642 Program scope Standard
G0644 Program data Standard
G0646 Program activities Standard
G0658 Performance improvement projects Standard
G0768 Competency evaluation Standard
G0774 12 hours inservice every 12 months Standard
G0436 Receive all services in plan of care Element
G0478 Investigate complaints made by patient Element
G0574 Plan of care must include the following Element
G0580 Only as ordered by a physician Element
G0754 A qualified HH aide successfully completed: Element
G0778 Documentation of inservice training Element
G0800 Services provided by HH aide Element
G0808 Onsite supervisory visit every 14 days Element
G0812 Direct observation every 12 months Element
G0948 Responsible for all day-to-day operations Element
▼ 287146 Fidelity Home Health Care, Llc 6550 South 84th, Suite 100 A Omaha NE 7 (Kansas City) 06/28/2018 KOWK11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0570 Care planning, coordination, quality of care Condition
G0750 Home health aide services Condition
G0572 Plan of care Standard
G0768 Competency evaluation Standard
G0774 12 hours inservice every 12 months Standard
G1024 Authentication Standard
G0412 Written notice of patient's rights Element
G0420 [Removed and Reserved] Element
G0436 Receive all services in plan of care Element
G0574 Plan of care must include the following Element
G0576 All orders recorded in plan of care Element
G0580 Only as ordered by a physician Element
G0778 Documentation of inservice training Element
G0808 Onsite supervisory visit every 14 days Element
G0812 Direct observation every 12 months Element
G0968 Assure implementation of plan of care Element
G1012 Required items in clinical record Element
G1022 Discharge and transfer summaries Element
▼ 287147 Personal Health Care Services, Llc 11319 P Street, Suite 2b Omaha NE 7 (Kansas City) 06/19/2019 JHMJ11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0750 Home health aide services Condition
G0798 Home health aide assignments and duties Standard
G0772 Documentation of competency evaluation Element
G0800 Services provided by HH aide Element
G0808 Onsite supervisory visit every 14 days Element
▼ 287151 Hrs Of Nebraska, Inc. 900 S 74th Plaza, Suite 111 Omaha NE 7 (Kansas City) 03/07/2024 62809-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0700 Skilled professional services Condition
G1008 Clinical records Condition
G0706 Interdisciplinary assessment of the patient Element
G0710 Provide services in the plan of care Element
G0718 Communication with physicians Element
G1012 Required items in clinical record Element
▼ 287152 Home Health Of Midwest Covenant Home 705 E 9th Stromsburg NE 7 (Kansas City) 04/10/2019 MVWG11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0570 Care planning, coordination, quality of care Condition
G0572 Plan of care Standard
G0414 HHA administrator contact information Element