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
▼ 347232 Interim Healthcare Of The Triad, Inc 2100-T West Cornwallis Drive Greensboro NC 4 (Atlanta) 10/03/2023 61275-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
G0536 A review of all current medications Element
▼ 347232 Interim Healthcare Of The Triad, Inc 2100-T West Cornwallis Drive Greensboro NC 4 (Atlanta) 07/08/2021 113A4-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0544 Update of the comprehensive assessment Standard
G0578 Conformance with physician orders Standard
▼ 347233 Interim Healthcare 200 1st Ave Nw Suite 314 Hickory NC 4 (Atlanta) 03/13/2019 YX3111 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
G0574 Plan of care must include the following Element
G0706 Interdisciplinary assessment of the patient Element
G0716 Preparing clinical notes Element
G0718 Communication with physicians Element
▼ 347234 Interim Healthcare Of The Triad Inc. 300 Billingsley Road Charlotte NC 4 (Atlanta) 06/11/2026 235332-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
▼ 347234 Interim Healthcare Of The Triad Inc. 300 Billingsley Road Charlotte NC 4 (Atlanta) 06/15/2023 5F7AF-H1 Complaint, 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
G0578 Conformance with physician orders Standard
G0704 Responsibilities of skilled professionals Standard
G0798 Home health aide assignments and duties Standard
G0520 5 calendar days after start of care 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
G0602 Communication with all physicians Element
G0714 Patient and caregiver education Element
G0808 Onsite supervisory visit every 14 days Element
G1012 Required items in clinical record Element
G1014 Interventions and patient response Element
▼ 347234 Interim Healthcare Of The Triad Inc. 300 Billingsley Road Charlotte NC 4 (Atlanta) 03/03/2021 TH2M11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0708 Development and evaluation of plan of care Element
G0710 Provide services in the plan of care Element
G0716 Preparing clinical notes Element
▼ 347236 Capital Care Resources Llc 1738 Hillandale Road, Suite A Durham NC 4 (Atlanta) 06/26/2019 XERG11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0434 Participate in care Element
▼ 347237 Medi Home Health Agency 9131 Anson Way 204 Raleigh NC 4 (Atlanta) 03/15/2023 5F431-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
G0682 Infection Prevention Standard
G0798 Home health aide assignments and duties Standard
G0574 Plan of care must include the following Element
G0590 Promptly alert relevant physician of changes Element
G0602 Communication with all physicians Element
G0710 Provide services in the plan of care Element
G1012 Required items in clinical record Element
▼ 347237 Medi Home Health Agency 9131 Anson Way 204 Raleigh NC 4 (Atlanta) 02/17/2021 HW9811 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
G0708 Development and evaluation of plan of care Element
G0710 Provide services in the plan of care Element
G0800 Services provided by HH aide Element
▼ 347239 Liberty Home Care 3134 Wendell Blvd, Level A Wendell NC 4 (Atlanta) 06/24/2025 66766-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0654 Track adverse patient events Standard
G0682 Infection Prevention Standard
G0488 Immediate reporting of abuse by all staff Element