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
▼ 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
▼ 058221 Medcare Home Health Services, Inc 14621 Titus Street, Ste 203 Panorama City CA 9 (San Francisco) 03/07/2022 385F3-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0962 Coordinate patient care Element
▼ 058221 Medcare Home Health Services, Inc 14621 Titus Street, Ste 203 Panorama City CA 9 (San Francisco) 08/17/2018 O3ET11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0682 Infection Prevention Standard
G0522 Eligibility for Medicare home health benefit Element
G0574 Plan of care must include the following Element
G0710 Provide services in the plan of care Element
G0714 Patient and caregiver education Element
▼ 058224 Mother Theresa's Home Health Services, Inc 847 N. Hollywood Way, # 203 Burbank CA 9 (San Francisco) 02/27/2022 385BF-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0798 Home health aide assignments and duties Standard
G0522 Eligibility for Medicare home health benefit Element
G0536 A review of all current medications Element
G0580 Only as ordered by a physician Element
G0620 Other pertinent instructions Element
G0710 Provide services in the plan of care Element
G0808 Onsite supervisory visit every 14 days Element
▼ 058224 Mother Theresa's Home Health Services, Inc 847 N. Hollywood Way, # 203 Burbank CA 9 (San Francisco) 08/31/2018 5OVB11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0544 Update of the comprehensive assessment Standard
G0466 Make efforts to resolve the problem(s) Element
G0710 Provide services in the plan of care Element
▼ 058228 Star Home Health Services, Inc. 8880 Benson Avenue Suite 108 Montclair CA 9 (San Francisco) 11/01/2019 8LZU11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0037 EP Training Program Standard
G0682 Infection Prevention Standard
G1024 Authentication Standard
G0596 Revisions communicated to patient and MDs Element
G0808 Onsite supervisory visit every 14 days Element
▼ 058230 Care Center Home Health, Inc 14762 Beach Blvd La Mirada CA 9 (San Francisco) 04/11/2022 38833-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
G0572 Plan of care Standard
G0644 Program data Standard
G0658 Performance improvement projects Standard
G0684 Infection control Standard
G0516 Skilled professional performs assessment Element
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0706 Interdisciplinary assessment of the patient Element
G0716 Preparing clinical notes Element
G0778 Documentation of inservice training Element
G1022 Discharge and transfer summaries Element
▼ 058233 Compassionate Care Home Health Agency 7545 N Del Mar Avenue, Suite 103 Fresno CA 9 (San Francisco) 06/25/2024 636A5-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0606 Integrate all services Element
G0714 Patient and caregiver education Element
G0716 Preparing clinical notes Element