S&C QCOR HHA 2567s
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HHAs 2567s
Selection Criteria ▸

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
▼ 337086 Franklin County Public Health Services Chha 355 West Main Street Malone NY 2 (New York) 10/10/2024 646B4-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0372 Encoding and transmitting OASIS Standard
G0798 Home health aide assignments and duties Standard
G0434 Participate in care Element
G0440 Payment from federally funded programs Element
G0514 RN performs assessment Element
G0520 5 calendar days after start of care Element
G0528 Health, psychosocial, functional, cognition Element
G0546 Last 5 days of every 60 days unless: Element
G0574 Plan of care must include the following Element
G0590 Promptly alert relevant physician of changes Element
▼ 337086 Franklin County Public Health Services Chha 355 West Main Street Malone NY 2 (New York) 08/10/2022 37E47-H2 Recertification
Deficiency Tag Deficiency Description Tag Type
G0536 A review of all current medications Element
▼ 337086 Franklin County Public Health Services Chha 355 West Main Street Malone NY 2 (New York) 11/04/2021 37E47-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G1010 Contents of clinical record Standard
G0574 Plan of care must include the following Element
G0590 Promptly alert relevant physician of changes Element
▼ 337086 Franklin County Public Health Services Chha 355 West Main Street Malone NY 2 (New York) 11/16/2018 TTGZ11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G1010 Contents of clinical record Standard
G0434 Participate in care Element
G0574 Plan of care must include the following Element
G0590 Promptly alert relevant physician of changes Element
G0802 Duties of a HH aide Element
▼ 337107 Good Samaritan Hospital Of Suffern, Inc. One Crosfield Avenue, 2nd Floor West Nyack NY 2 (New York) 09/29/2021 8HMU11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0434 Participate in care Element
G0590 Promptly alert relevant physician of changes Element
▼ 337107 Good Samaritan Hospital Of Suffern, Inc. One Crosfield Avenue, 2nd Floor West Nyack NY 2 (New York) 12/11/2018 6FIY11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0578 Conformance with physician orders Standard
G0682 Infection Prevention Standard
G0590 Promptly alert relevant physician of changes Element
▼ 337108 Long Island Community Hospital Home Care 103 West Main Street Patchogue NY 2 (New York) 10/02/2020 HRIR11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0578 Conformance with physician orders Standard
▼ 337118 County Of Essex 132 Water Street Elizabethtown NY 2 (New York) 04/14/2026 6601C-H2 Recertification
Deficiency Tag Deficiency Description Tag Type
G0798 Home health aide assignments and duties Standard
G1014 Interventions and patient response Element
▼ 337118 County Of Essex 132 Water Street Elizabethtown NY 2 (New York) 04/24/2025 6601C-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0372 Encoding and transmitting OASIS Standard
G0574 Plan of care must include the following Element
G0590 Promptly alert relevant physician of changes Element
▼ 337118 County Of Essex 132 Water Street Elizabethtown NY 2 (New York) 04/25/2023 4EE0C-H2 Focused Infection Control, Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0574 Plan of care must include the following Element