S&C QCOR HHA 2567s
d QCOR:  Quality, Certification and Oversight Reports.
HHAs 2567s
Selection Criteria

Time Interval

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Provider Characteristics

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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
058207 Legacy Health Care Providers Inc 1272 E Center Court Dr Suite 203 Covina CA 9 (San Francisco) 07/24/2022 4F179-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0004 Develop EP Plan, Review and Update Annually Standard
G0684 Infection control Standard
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
058207 Legacy Health Care Providers Inc 1272 E Center Court Dr Suite 203 Covina CA 9 (San Francisco) 11/30/2018 4R5011 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0522 Eligibility for Medicare home health benefit Element
G0536 A review of all current medications Element
058212 Excell Home Care Inc 14023 Paramount Blvd Paramount CA 9 (San Francisco) 12/08/2023 61AAF-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0612 Written instructions to patient include: Standard
G0682 Infection Prevention Standard
G0536 A review of all current medications Element
G0616 Patient medication schedule/instructions Element
058213 Intensive Home Health Care, Inc 21671 Gateway Center Suite 104 Diamond Bar CA 9 (San Francisco) 04/08/2021 2XK211 Complaint, Sample Validation
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0436 Receive all services in plan of care Element
G0536 A review of all current medications Element
G0984 In accordance with current clinical practice Element
058216 Rehabfocus Home Health, Inc 4643 Quail Lakes Drive Stockton CA 9 (San Francisco) 01/06/2026 1DEE46-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0434 Participate in care Element
G0614 Visit schedule Element
058216 Rehabfocus Home Health, Inc 4643 Quail Lakes Drive Stockton CA 9 (San Francisco) 02/02/2023 5ED37-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0580 Only as ordered by a physician Element
G0616 Patient medication schedule/instructions Element
G0710 Provide services in the plan of care Element
G0718 Communication with physicians Element
058216 Rehabfocus Home Health, Inc 4643 Quail Lakes Drive Stockton CA 9 (San Francisco) 02/07/2019 9YDG11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0580 Only as ordered by a physician Element
058217 Bradbourne Healthcare, Inc 1109 W San Bernardino Rd, Ste 230 Covina CA 9 (San Francisco) 06/17/2022 4EDD8-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0374 Accuracy of encoded OASIS data Standard
G0572 Plan of care Standard
G0682 Infection Prevention Standard
G0684 Infection control Standard
G0574 Plan of care must include the following Element
G0808 Onsite supervisory visit every 14 days Element
058219 Select Care Home Health Services Inc 3071 W Olympic Blvd., Unit 102 Los Angeles CA 9 (San Francisco) 04/03/2022 387FC-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0004 Develop EP Plan, Review and Update Annually Standard
G0682 Infection Prevention Standard
G0984 In accordance with current clinical practice Element
058219 Select Care Home Health Services Inc 3071 W Olympic Blvd., Unit 102 Los Angeles CA 9 (San Francisco) 12/17/2018 VB4X11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0578 Conformance with physician orders Standard
G0522 Eligibility for Medicare home health benefit Element
G0536 A review of all current medications Element
G0710 Provide services in the plan of care Element