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
▼ 347113 Carolinas Medical Center At Home Lllc 901 North Second Street Albemarle NC 4 (Atlanta) 09/01/2022 4EFE4-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0704 Responsibilities of skilled professionals Standard
G0574 Plan of care must include the following Element
G0716 Preparing clinical notes Element
G1014 Interventions and patient response Element
▼ 347114 Adoration Home Health Care Virginia Llc 9731 Southern Pine Blvd Suite L Charlotte NC 4 (Atlanta) 12/18/2023 61C2E-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0484 Document complaint and resolution Element
▼ 347114 Adoration Home Health Care Virginia Llc 9731 Southern Pine Blvd Suite L Charlotte NC 4 (Atlanta) 02/01/2021 JTWH11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0578 Conformance with physician orders Standard
G0484 Document complaint and resolution Element
▼ 347114 Adoration Home Health Care Virginia Llc 9731 Southern Pine Blvd Suite L Charlotte NC 4 (Atlanta) 10/14/2020 SZYU11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0578 Conformance with physician orders Standard
▼ 347119 Warren County Home Health Agen 544 A West Ridgeway Street Warrenton NC 4 (Atlanta) 03/12/2024 626EE-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
E0004 Develop EP Plan, Review and Update Annually Standard
E0039 EP Testing Requirements Standard
G0590 Promptly alert relevant physician of changes Element
▼ 347119 Warren County Home Health Agen 544 A West Ridgeway Street Warrenton NC 4 (Atlanta) 09/02/2021 19647-H1 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
G1012 Required items in clinical record Element
▼ 347120 Innovative Senior Care Home Health Of High Point Llc 7900 Triad Center Drive, Suite 250 Greensboro NC 4 (Atlanta) 02/12/2025 655EA-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0546 Last 5 days of every 60 days unless: Element
G0574 Plan of care must include the following Element
G0576 All orders recorded in plan of care Element
G0580 Only as ordered by a physician Element
G0602 Communication with all physicians Element
G0710 Provide services in the plan of care Element
▼ 347122 Adoration Home Health Care Virginia, Llc 1941 S Nc Highway 119 Mebane NC 4 (Atlanta) 09/03/2025 1D4EE0-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0608 Coordinate care delivery Element
▼ 347122 Adoration Home Health Care Virginia, Llc 1941 S Nc Highway 119 Mebane NC 4 (Atlanta) 05/21/2020 CW7Y11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0700 Skilled professional services Condition
G0710 Provide services in the plan of care Element
G0716 Preparing clinical notes Element
▼ 347123 Hospice At Greensboro, Inc. 914 Chapel Hill Road Burlington NC 4 (Atlanta) 02/19/2019 C49B11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0684 Infection control Standard
G0574 Plan of care must include the following Element