S&C QCOR HHA 2567s
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HHAs 2567s
Selection Criteria ▸

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
▼ 347334 Liberty Home Care 3414 N Duke Street, Suite 201 Durham NC 4 (Atlanta) 12/03/2019 QF3E11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
▼ 347334 Liberty Home Care 3414 N Duke Street, Suite 201 Durham NC 4 (Atlanta) 03/07/2019 9XUK11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G1010 Contents of clinical record Standard
▼ 347336 Well Care Home Health Of The Southern Triangle, Inc. 4928 Linksland Dr, Suite 340 Holly Springs NC 4 (Atlanta) 05/12/2025 662DD-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0514 RN performs assessment Element
G1022 Discharge and transfer summaries Element
▼ 347336 Well Care Home Health Of The Southern Triangle, Inc. 4928 Linksland Dr, Suite 340 Holly Springs NC 4 (Atlanta) 04/15/2024 62C10-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0682 Infection Prevention Standard
▼ 357002 Jamestown Hospital Home Health Agency 2422 20th St Sw Jamestown ND 8 (Denver) 10/05/2021 8RCQ11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0862 Laboratory services/CLIA waivers Standard
▼ 357004 Richland County Home Health Agency 413 3rd Ave N Wahpeton ND 8 (Denver) 02/16/2022 38361-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
▼ 357013 Chi - Health Connect At Home - Fargo 986 2nd Ave West Dickinson ND 8 (Denver) 07/31/2019 GCU611 Complaint, Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0580 Only as ordered by a physician Element
G0592 Revised plan of care Element
▼ 357014 Altru Health System 2401 Demers Ave Grand Forks ND 8 (Denver) 05/26/2022 4EADA-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
▼ 357016 Chi - Health Connect At Home - Fargo 1310 East Main Avenue Bismarck ND 8 (Denver) 01/14/2025 65021-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0808 Onsite supervisory visit every 14 days Element
▼ 357016 Chi - Health Connect At Home - Fargo 1310 East Main Avenue Bismarck ND 8 (Denver) 03/27/2019 R5O211 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0580 Only as ordered by a physician Element
G0592 Revised plan of care Element
G0710 Provide services in the plan of care Element
G0800 Services provided by HH aide Element