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
▼ 337225 Brooks-Tlc Hospital System, Inc. 12644 Seneca Road Irving NY 2 (New York) 08/31/2018 88F411 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
G0578 Conformance with physician orders Standard
G0862 Laboratory services/CLIA waivers Standard
G0418 Patient's or legal representative's signature Element
G0520 5 calendar days after start of care Element
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0718 Communication with physicians Element
G0800 Services provided by HH aide Element
▼ 337230 Health Quest Home Care, Inc. (Certified) 2649 South Road, Suite 220 Poughkeepsie NY 2 (New York) 04/26/2021 ZDD111 Focused Infection Control, Other-Fed, Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0578 Conformance with physician orders Standard
G0536 A review of all current medications 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
G0984 In accordance with current clinical practice Element
▼ 337230 Health Quest Home Care, Inc. (Certified) 2649 South Road, Suite 220 Poughkeepsie NY 2 (New York) 05/15/2018 6WS511 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
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
▼ 337232 Qc-Medi New York, Inc. 1393 Veterans Memorial Parkway Hauppauge NY 2 (New York) 10/30/2020 P4MN11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0578 Conformance with physician orders Standard
G0586 Review and revision of the plan of care Standard
G0704 Responsibilities of skilled professionals Standard
G0434 Participate in care Element
G0536 A review of all current medications Element
G0546 Last 5 days of every 60 days unless: Element
G0550 At discharge Element
G0574 Plan of care must include the following Element
G0606 Integrate all services Element
G0718 Communication with physicians Element
▼ 337234 Rosa Coplon Jewish Home And Infirmary 2700 North Forest Road Getzville NY 2 (New York) 02/01/2024 621B2-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0578 Conformance with physician orders Standard
G0516 Skilled professional performs assessment Element
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0598 Discharge plans communication Element
G0716 Preparing clinical notes Element
G0718 Communication with physicians Element
G1022 Discharge and transfer summaries Element
▼ 337234 Rosa Coplon Jewish Home And Infirmary 2700 North Forest Road Getzville NY 2 (New York) 11/02/2022 0X2J-H5 Focused Infection Control, Other-Fed, Recertification
Deficiency Tag Deficiency Description Tag Type
G0578 Conformance with physician orders Standard
G0716 Preparing clinical notes Element
▼ 337234 Rosa Coplon Jewish Home And Infirmary 2700 North Forest Road Getzville NY 2 (New York) 12/14/2021 0X2J-H2 Focused Infection Control, Other-Fed, Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0526 Content of the comprehensive assessment Standard
G0536 A review of all current medications Element
▼ 337234 Rosa Coplon Jewish Home And Infirmary 2700 North Forest Road Getzville NY 2 (New York) 03/18/2021 0X2J11 Focused Infection Control, Other-Fed, Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0374 Accuracy of encoded OASIS data Standard
G0526 Content of the comprehensive assessment Standard
G0586 Review and revision of the plan of care Standard
G0660 Executive responsibilities for QAPI Standard
G1024 Authentication Standard
G0440 Payment from federally funded programs Element
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0598 Discharge plans communication Element
G0608 Coordinate care delivery Element
G0716 Preparing clinical notes Element
G0718 Communication with physicians Element
G0984 In accordance with current clinical practice Element
▼ 337234 Rosa Coplon Jewish Home And Infirmary 2700 North Forest Road Getzville NY 2 (New York) 04/13/2018 9CV911 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0528 Health, psychosocial, functional, cognition Element
G0538 Primary caregiver(s), if any 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
G0606 Integrate all services Element
G0716 Preparing clinical notes Element
G0984 In accordance with current clinical practice Element
▼ 337237 Tri-Borough Certified Health Systems Of New York, Llc 50 Clinton Street, Suite 601 Hempstead NY 2 (New York) 02/27/2025 656BC-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0019 Homebound HHA/Hospice Inform EP Officials Standard
E0021 HHA- Procedures for Follow up Staff/Pts. Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0030 Names and Contact Information Standard
E0034 Information on Occupancy/Needs Standard
E0036 EP Training and Testing Standard
E0039 EP Testing Requirements Standard
G0372 Encoding and transmitting OASIS Standard
G0572 Plan of care Standard
G0642 Program scope Standard
G0644 Program data Standard
G0646 Program activities Standard
G0660 Executive responsibilities for QAPI Standard
G0684 Infection control Standard
G0436 Receive all services in plan of care Element
G0514 RN performs assessment Element
G0528 Health, psychosocial, functional, cognition Element
G0574 Plan of care must include the following Element
G0580 Only as ordered by a physician Element
G0608 Coordinate care delivery Element
G0728 Rehab services supervised by PT, OT Element
G1012 Required items in clinical record Element