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
▼ 337423 Hiram Certified Home Care Company 2150 Bleecker Street Utica NY 2 (New York) 07/19/2023 6077D-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0526 Content of the comprehensive assessment Standard
G0798 Home health aide assignments and duties Standard
G0574 Plan of care must include the following Element
G0606 Integrate all services Element
▼ 337423 Hiram Certified Home Care Company 2150 Bleecker Street Utica NY 2 (New York) 08/04/2020 G5TF11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0526 Content of the comprehensive assessment Standard
G0798 Home health aide assignments and duties Standard
G0514 RN performs assessment Element
G0574 Plan of care must include the following Element
▼ 337424 Excellent Home Care Services Llc 12 Spencer Street Brooklyn NY 2 (New York) 02/24/2021 XDIK11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0608 Coordinate care delivery Element
▼ 337424 Excellent Home Care Services Llc 12 Spencer Street Brooklyn NY 2 (New York) 07/18/2019 PS2411 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
▼ 337424 Excellent Home Care Services Llc 12 Spencer Street Brooklyn NY 2 (New York) 01/08/2019 WRBE11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0514 RN performs assessment Element
▼ 337425 Premier Home Health Care Services, Inc. 5 Bryant Park, 1065 Avenue Of The Americas, 5th Fl New York NY 2 (New York) 12/03/2020 UUMB11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
E0013 Development of EP Policies and Procedures Standard
G0646 Program activities Standard
G0658 Performance improvement projects Standard
G0798 Home health aide assignments and duties Standard
G0414 HHA administrator contact information Element
G0416 OASIS privacy notice Element
G0430 Be free from abuse Element
G0438 Have a confidential clinical record Element
G0446 Contact info Federal/State-funded entities Element
G0450 Access to auxiliary aids and language service Element
G0528 Health, psychosocial, functional, cognition Element
G0574 Plan of care must include the following Element
G0718 Communication with physicians Element
G0808 Onsite supervisory visit every 14 days Element
G0948 Responsible for all day-to-day operations Element
▼ 337425 Premier Home Health Care Services, Inc. 5 Bryant Park, 1065 Avenue Of The Americas, 5th Fl New York NY 2 (New York) 01/11/2018 3QJY11 Complaint, Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0158 ACCEPTANCE OF PATIENTS, POC, MED SUPER Standard
G0159 PLAN OF CARE Standard
G0164 PERIODIC REVIEW OF PLAN OF CARE Standard
G0165 CONFORMANCE WITH PHYSICIAN ORDERS Standard
G0224 ASSIGNMENT & DUTIES OF HOME HEALTH AIDE Standard
G0324 TRANSMITTAL OF OASIS DATA Standard
▼ 337430 United Odd Fellow & Rebekah Home, Inc. 1040 Havemeyer Avenue Bronx NY 2 (New York) 01/17/2025 65255-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0374 Accuracy of encoded OASIS data Standard
G0572 Plan of care Standard
G0686 Infection control education Standard
G0798 Home health aide assignments and duties Standard
G0468 Provide contact info other services Element
G0514 RN performs assessment Element
G0528 Health, psychosocial, functional, cognition Element
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
G0620 Other pertinent instructions Element
G0710 Provide services in the plan of care Element
G0808 Onsite supervisory visit every 14 days Element
▼ 337430 United Odd Fellow & Rebekah Home, Inc. 1040 Havemeyer Avenue Bronx NY 2 (New York) 02/11/2022 384AF-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0586 Review and revision of the plan of care Standard
G0514 RN performs assessment Element
G0536 A review of all current medications 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
G0710 Provide services in the plan of care Element
G0808 Onsite supervisory visit every 14 days Element
▼ 337430 United Odd Fellow & Rebekah Home, Inc. 1040 Havemeyer Avenue Bronx NY 2 (New York) 03/15/2019 X48Z11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0374 Accuracy of encoded OASIS data Standard
G0572 Plan of care Standard
G0798 Home health aide assignments and duties Standard
G0414 HHA administrator contact information Element
G0430 Be free from abuse Element
G0432 Make complaints to the HHA Element
G0434 Participate in care Element
G0440 Payment from federally funded programs Element
G0450 Access to auxiliary aids and language service Element
G0536 A review of all current medications Element
G0550 At discharge Element
G0574 Plan of care must include the following Element
G0580 Only as ordered by a physician Element
G0584 Verbal orders Element
G0718 Communication with physicians Element
G0726 Nursing services supervised by RN Element
G0808 Onsite supervisory visit every 14 days Element
G1022 Discharge and transfer summaries Element