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
▼ 347241 Five Points Healthcare Of Nc Llc 3107 Raeford Road Fayetteville NC 4 (Atlanta) 03/24/2022 38647-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0576 All orders recorded in plan of care Element
G0580 Only as ordered by a physician Element
G0606 Integrate all services Element
▼ 347241 Five Points Healthcare Of Nc Llc 3107 Raeford Road Fayetteville NC 4 (Atlanta) 04/11/2019 5DMM11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0574 Plan of care must include the following Element
▼ 347242 Liberty Home Care Ii, Llc 2015 Moore Road Matthews NC 4 (Atlanta) 01/17/2024 61FA4-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
G0798 Home health aide assignments and duties Standard
G0574 Plan of care must include the following Element
G0580 Only as ordered by a physician Element
G0602 Communication with all physicians Element
G0716 Preparing clinical notes Element
▼ 347242 Liberty Home Care Ii, Llc 2015 Moore Road Matthews NC 4 (Atlanta) 07/07/2021 113A3-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0602 Communication with all physicians Element
G0710 Provide services in the plan of care Element
▼ 347243 Bayada Home Health Care, Inc. 4000 Westchase Blvd, Suite 190 Raleigh NC 4 (Atlanta) 01/22/2026 1E097C-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
G0800 Services provided by HH aide Element
G0818 HH aide supervision elements Element
▼ 347243 Bayada Home Health Care, Inc. 4000 Westchase Blvd, Suite 190 Raleigh NC 4 (Atlanta) 11/07/2023 616CF-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0484 Document complaint and resolution Element
G0706 Interdisciplinary assessment of the patient Element
▼ 347243 Bayada Home Health Care, Inc. 4000 Westchase Blvd, Suite 190 Raleigh NC 4 (Atlanta) 02/23/2023 5F198-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
G0604 Integrate all orders Element
▼ 347243 Bayada Home Health Care, Inc. 4000 Westchase Blvd, Suite 190 Raleigh NC 4 (Atlanta) 02/04/2021 1VRH11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0484 Document complaint and resolution Element
G0590 Promptly alert relevant physician of changes Element
G0710 Provide services in the plan of care Element
G0716 Preparing clinical notes Element
▼ 347244 Personal Home Care Of North Carolina, Llc 1515 Mockingbird Lane Ste 520b Charlotte NC 4 (Atlanta) 12/05/2018 OVRG11 Recertification, Sample Validation
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
▼ 347245 Liberty Home Care, Llc 705 B Wesley Pine Road Lumberton NC 4 (Atlanta) 10/10/2023 5F7AE-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
G0520 5 calendar days after start of care Element
G0574 Plan of care must include the following Element
G0590 Promptly alert relevant physician of changes Element
G1012 Required items in clinical record Element