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
▼ 307085 Maxim Healthcare Services Inc 1750 Elm Street Suite 602 Manchester NH 1 (Boston) 07/17/2024 63A25-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0004 Develop EP Plan, Review and Update Annually Standard
E0006 Plan Based on All Hazards Risk Assessment Standard
E0009 Local, State, Tribal Collaboration Process Standard
E0019 Homebound HHA/Hospice Inform EP Officials Standard
E0021 HHA- Procedures for Follow up Staff/Pts. Standard
E0030 Names and Contact Information Standard
E0031 Emergency Officials Contact Information Standard
E0033 Methods for Sharing Information Standard
E0034 Information on Occupancy/Needs Standard
E0036 EP Training and Testing Standard
E0037 EP Training Program Standard
E0039 EP Testing Requirements Standard
G0372 Encoding and transmitting OASIS Standard
G0572 Plan of care Standard
G0436 Receive all services in plan of care Element
▼ 307085 Maxim Healthcare Services Inc 1750 Elm Street Suite 602 Manchester NH 1 (Boston) 10/06/2021 DBO211 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0684 Infection control Standard
▼ 307085 Maxim Healthcare Services Inc 1750 Elm Street Suite 602 Manchester NH 1 (Boston) 04/12/2018 B86X11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0578 Conformance with physician orders Standard
G0444 State toll free HH telephone hotline Element
G0608 Coordinate care delivery Element
▼ 307088 J&K Staffing Solutions, Llc 12 Stiles Road Salem NH 1 (Boston) 11/25/2025 1DC538-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
E0009 Local, State, Tribal Collaboration Process Standard
E0019 Homebound HHA/Hospice Inform EP Officials Standard
E0021 HHA- Procedures for Follow up Staff/Pts. Standard
E0031 Emergency Officials Contact Information Standard
▼ 307088 J&K Staffing Solutions, Llc 12 Stiles Road Salem NH 1 (Boston) 12/16/2019 HZVH11 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
G0406 Patient rights Condition
E0004 Develop EP Plan, Review and Update Annually Standard
E0029 Development of Communication Plan Standard
E0036 EP Training and Testing Standard
G0436 Receive all services in plan of care Element
G0454 HHA can no longer meet the patient's needs Element
G0718 Communication with physicians Element
▼ 307089 Hampstead Home Health Care, Inc 10 Bricketts Mill Rd Hampstead NH 1 (Boston) 07/11/2019 6CTO11 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
E0004 Develop EP Plan, Review and Update Annually Standard
E0006 Plan Based on All Hazards Risk Assessment Standard
E0009 Local, State, Tribal Collaboration Process Standard
E0013 Development of EP Policies and Procedures Standard
E0036 EP Training and Testing Standard
E0037 EP Training Program Standard
E0039 EP Testing Requirements Standard
G0376 Transmittal of OASIS data Standard
G0578 Conformance with physician orders 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
G0774 12 hours inservice every 12 months Standard
G0942 Governing body Standard
G0442 Written notice for non-covered care Element
G0648 High risk, high volume, or problem-prone area Element
G0650 Incidence, prevalence, severity of problems Element
G0652 Activities lead to an immediate correction Element
G0656 Improvements are sustained Element
G0954 Ensures qualified pre-designated person Element
▼ 307092 Bell Tower Home Health 402 Amherst Street Ste 101 Nashua NH 1 (Boston) 12/05/2019 K7HM11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0614 Visit schedule Element
G0814 Non-skilled direct observation every 60 days Element
▼ 307093 Caretenders 285 Calef Hwy, Ste 106 Epping NH 1 (Boston) 09/26/2024 643D5-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
E0009 Local, State, Tribal Collaboration Process Standard
E0021 HHA- Procedures for Follow up Staff/Pts. Standard
E0039 EP Testing Requirements Standard
G0372 Encoding and transmitting OASIS Standard
G0572 Plan of care Standard
G0410 Information to patient Element
G0418 Patient's or legal representative's signature Element
G0576 All orders recorded in plan of care Element
▼ 307094 Comfort Angels Home Care Of Nh, Llc 1 Chestnut St Ste 337 Nashua NH 1 (Boston) 02/14/2018 N2UO11 Initial Certification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0442 Written notice for non-covered care Element
G0444 State toll free HH telephone hotline Element
G0522 Eligibility for Medicare home health benefit Element
▼ 317002 Visiting Nurse Association Of Northern New Jersey, Inc. 175 South Street Morristown NJ 2 (New York) 02/10/2021 5NOT11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0702 Services by skilled professionals Standard
G0574 Plan of care must include the following Element
G0606 Integrate all services Element
G0710 Provide services in the plan of care Element