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
▼ 347007 American Healthcare Systems Llc 212 Foust St Asheboro NC 4 (Atlanta) 05/09/2019 RZ8W11 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
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0718 Communication with physicians Element
▼ 347011 Innovative Senior Care Home Health Of Durham Llc 1009 Slater Road Ste 410 Durham NC 4 (Atlanta) 02/21/2024 63864-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0704 Responsibilities of skilled professionals Standard
G0488 Immediate reporting of abuse by all staff Element
G0520 5 calendar days after start of care Element
G0574 Plan of care must include the following Element
G0580 Only as ordered by a physician Element
G0716 Preparing clinical notes Element
▼ 347013 Carolinas Medical Center At Home, Llc 105 T R Harris Dr Shelby NC 4 (Atlanta) 06/19/2025 66841-H1 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
G0682 Infection Prevention Standard
G0574 Plan of care must include the following Element
▼ 347013 Carolinas Medical Center At Home, Llc 105 T R Harris Dr Shelby NC 4 (Atlanta) 06/21/2022 4EAF7-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0536 A review of all current medications Element
G0602 Communication with all physicians Element
▼ 347013 Carolinas Medical Center At Home, Llc 105 T R Harris Dr Shelby NC 4 (Atlanta) 06/05/2019 ROXE11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0536 A review of all current medications Element
G0602 Communication with all physicians Element
▼ 347014 Good Shepherd Acquisition Llc 3280 Nc Highway 69 Hayesville NC 4 (Atlanta) 03/04/2026 1F2451-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0536 A review of all current medications Element
G0808 Onsite supervisory visit every 14 days Element
▼ 347014 Good Shepherd Acquisition Llc 3280 Nc Highway 69 Hayesville NC 4 (Atlanta) 03/20/2019 4QBB11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0378 OASIS data transmission format Element
G0536 A review of all current medications Element
▼ 347015 Pruitthealth Home Health Inc 502 S Key Street Suite 102 Pilot Mountain NC 4 (Atlanta) 12/11/2019 47CG11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0574 Plan of care must include the following Element
▼ 347017 Msa Home Health And Hospice Of Nc, Inc. 1129 Horseshoe Road Elizabeth City NC 4 (Atlanta) 04/30/2025 66017-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0682 Infection Prevention Standard
G0704 Responsibilities of skilled professionals Standard
G0574 Plan of care must include the following Element
G0716 Preparing clinical notes Element
▼ 347017 Msa Home Health And Hospice Of Nc, Inc. 1129 Horseshoe Road Elizabeth City NC 4 (Atlanta) 06/09/2022 38259-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0682 Infection Prevention Standard
G0574 Plan of care must include the following Element
G0576 All orders recorded in plan of care Element
G0590 Promptly alert relevant physician of changes Element
G0710 Provide services in the plan of care Element