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
▼ 058198 Muliti-Skilled Home Care Services, Inc 19608 Camino De Rosa, Suite 201 Walnut CA 9 (San Francisco) 02/06/2022 383F9-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
G0682 Infection Prevention Standard
G0536 A review of all current medications Element
G0580 Only as ordered by a physician Element
G0590 Promptly alert relevant physician of changes Element
G0710 Provide services in the plan of care Element
G0716 Preparing clinical notes Element
▼ 058198 Muliti-Skilled Home Care Services, Inc 19608 Camino De Rosa, Suite 201 Walnut CA 9 (San Francisco) 01/29/2018 7SMP11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0518 Completion of the comprehensive assessment Standard
G1010 Contents of clinical record Standard
G0576 All orders recorded in plan of care Element
G0710 Provide services in the plan of care Element
G0728 Rehab services supervised by PT, OT Element
G0808 Onsite supervisory visit every 14 days Element
▼ 058200 Sunrise Home Care Services Inc 941 S Atlantic Blvd, Ste 222 Monterey Park CA 9 (San Francisco) 01/13/2023 5E89C-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0510 Comprehensive Assessment of Patients Condition
G0570 Care planning, coordination, quality of care Condition
G0640 Quality assessment/performance improvement Condition
E0004 Develop EP Plan, Review and Update Annually Standard
G0572 Plan of care Standard
G0642 Program scope Standard
G0644 Program data Standard
G0682 Infection Prevention 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
G0588 Reviewed, revised by physician every 60 days Element
G0590 Promptly alert relevant physician of changes Element
G0610 Patients receive education and training Element
G0616 Patient medication schedule/instructions Element
▼ 058200 Sunrise Home Care Services Inc 941 S Atlantic Blvd, Ste 222 Monterey Park CA 9 (San Francisco) 01/27/2020 HK9111 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0710 Provide services in the plan of care Element
▼ 058201 Agape Home Health Services, Inc 1661 Hanover Road Suite 226 City Of Industry CA 9 (San Francisco) 06/02/2022 4EC57-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0570 Care planning, coordination, quality of care Condition
E0004 Develop EP Plan, Review and Update Annually Standard
G0572 Plan of care Standard
G0658 Performance improvement projects Standard
G0682 Infection Prevention Standard
G0536 A review of all current medications Element
G0580 Only as ordered by a physician Element
G0710 Provide services in the plan of care Element
G1022 Discharge and transfer summaries Element
▼ 058201 Agape Home Health Services, Inc 1661 Hanover Road Suite 226 City Of Industry CA 9 (San Francisco) 09/24/2018 2M2C11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0536 A review of all current medications Element
G0580 Only as ordered by a physician Element
▼ 058202 L. A. Family Home Health Inc 1301 W 2nd Street, Suite 206 Los Angeles CA 9 (San Francisco) 11/13/2022 5E430-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
G0682 Infection Prevention Standard
G0514 RN performs assessment Element
G0580 Only as ordered by a physician Element
G0590 Promptly alert relevant physician of changes Element
G0608 Coordinate care delivery Element
▼ 058202 L. A. Family Home Health Inc 1301 W 2nd Street, Suite 206 Los Angeles CA 9 (San Francisco) 11/05/2019 CGP211 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0522 Eligibility for Medicare home health benefit Element
G0536 A review of all current medications Element
G0580 Only as ordered by a physician Element
▼ 058203 Heralds Home Health 13047 Artesia Blvd, Ste C200 1/2 Cerritos CA 9 (San Francisco) 01/29/2026 1DA1AF-H2 Complaint
Deficiency Tag Deficiency Description Tag Type
G0374 Accuracy of encoded OASIS data Standard
G0682 Infection Prevention Standard
G0574 Plan of care must include the following Element
G0576 All orders recorded in plan of care Element
G0588 Reviewed, revised by physician every 60 days Element
▼ 058203 Heralds Home Health 13047 Artesia Blvd, Ste C200 1/2 Cerritos CA 9 (San Francisco) 10/22/2025 1DA1AF-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0370 Reporting OASIS information Condition
G0570 Care planning, coordination, quality of care Condition
G0940 Organization and administration of services Condition
G0372 Encoding and transmitting OASIS Standard
G0572 Plan of care Standard
G0534 Patient's needs Element
G0580 Only as ordered by a physician Element
G0604 Integrate all orders Element
G0610 Patients receive education and training Element
G0964 Coordinate referrals; Element
G1022 Discharge and transfer summaries Element