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
▼ 347169 North Carolina In-Home Partner-V, Llc 500 West St, Suite A1 Spindale NC 4 (Atlanta) 03/29/2018 QW8H11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0700 Skilled professional services Condition
G0544 Update of the comprehensive assessment Standard
G0434 Participate in care Element
G0536 A review of all current medications Element
G0706 Interdisciplinary assessment of the patient Element
G0710 Provide services in the plan of care Element
G0716 Preparing clinical notes Element
G0718 Communication with physicians Element
G0800 Services provided by HH aide Element
G0818 HH aide supervision elements Element
G1022 Discharge and transfer summaries Element
▼ 347172 Eraj Holdings, Llc 336 N. South Street Mount Airy NC 4 (Atlanta) 09/09/2025 1D62B6-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
▼ 347172 Eraj Holdings, Llc 336 N. South Street Mount Airy NC 4 (Atlanta) 09/14/2022 4F020-H1 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
G0798 Home health aide assignments and duties Standard
G0574 Plan of care must include the following Element
G0602 Communication with all physicians Element
G0718 Communication with physicians Element
G1012 Required items in clinical record Element
G1022 Discharge and transfer summaries Element
▼ 347172 Eraj Holdings, Llc 336 N. South Street Mount Airy NC 4 (Atlanta) 09/25/2019 RXE811 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
G0576 All orders recorded in plan of care Element
▼ 347173 Caresouth Hha Holdings Of Greensboro, Llc 5 Oak Branch Drive, Ste 5e Greensboro NC 4 (Atlanta) 10/30/2024 64941-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
G0580 Only as ordered by a physician Element
G0590 Promptly alert relevant physician of changes Element
▼ 347173 Caresouth Hha Holdings Of Greensboro, Llc 5 Oak Branch Drive, Ste 5e Greensboro NC 4 (Atlanta) 05/22/2023 5FE84-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0442 Written notice for non-covered care Element
G0484 Document complaint and resolution Element
G1022 Discharge and transfer summaries Element
▼ 347173 Caresouth Hha Holdings Of Greensboro, Llc 5 Oak Branch Drive, Ste 5e Greensboro NC 4 (Atlanta) 04/06/2022 38644-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0700 Skilled professional services Condition
G0578 Conformance with physician orders Standard
G0682 Infection Prevention Standard
G0574 Plan of care must include the following Element
G0580 Only as ordered by a physician Element
G0706 Interdisciplinary assessment of the patient Element
G0718 Communication with physicians Element
▼ 347173 Caresouth Hha Holdings Of Greensboro, Llc 5 Oak Branch Drive, Ste 5e Greensboro NC 4 (Atlanta) 12/16/2019 70B411 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0580 Only as ordered by a physician Element
▼ 347173 Caresouth Hha Holdings Of Greensboro, Llc 5 Oak Branch Drive, Ste 5e Greensboro NC 4 (Atlanta) 02/27/2019 8DSK11 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
G0580 Only as ordered by a physician Element
G0710 Provide services in the plan of care Element
G1014 Interventions and patient response Element
▼ 347175 Healthview Home Health & Hospice-Caswell Llc 1080 Nc Highway 86 N Yanceyville NC 4 (Atlanta) 01/11/2023 5EB3D-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0578 Conformance with physician orders Standard