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
▼ 367249 Kettering Medical Center Inc 1050 Forrer Blvd, Suite 105 Kettering OH 5 (Chicago) 12/21/2020 0P3R11 Complaint, Focused Infection Control, Other-Fed
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0686 Infection control education Standard
▼ 367253 Southwest General Home Health Llc 7575 Old Oak Blvd Middleburg Heights OH 5 (Chicago) 04/28/2022 38936-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0608 Coordinate care delivery Element
▼ 367256 Mercy Medical Center Home Health & Hospice Llc 4369 Whipple Avenue Nw Canton OH 5 (Chicago) 08/10/2020 Q8EQ11 Complaint, Focused Infection Control, Other-Fed
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0684 Infection control Standard
▼ 367261 Heartland Home Care Llc 5855 Monroe Street Sylvania OH 5 (Chicago) 11/27/2019 1DXE11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0578 Conformance with physician orders Standard
▼ 367296 Home Health Care By Black Stone 8230 Montgomery Road, Suite 210 Cincinnati OH 5 (Chicago) 12/13/2018 7THX11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0580 Only as ordered by a physician Element
G0590 Promptly alert relevant physician of changes Element
▼ 367323 Interim Healthcare Of Columbus 2682 North Columbus Street, Suite A Lancaster OH 5 (Chicago) 12/30/2020 TLZN11 Complaint, Focused Infection Control, Other-Fed
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0436 Receive all services in plan of care Element
▼ 367323 Interim Healthcare Of Columbus 2682 North Columbus Street, Suite A Lancaster OH 5 (Chicago) 08/03/2020 YIV311 Complaint, Focused Infection Control, Other-Fed
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0578 Conformance with physician orders Standard
G0608 Coordinate care delivery Element
G0718 Communication with physicians Element
▼ 367323 Interim Healthcare Of Columbus 2682 North Columbus Street, Suite A Lancaster OH 5 (Chicago) 11/19/2018 3JFN11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0478 Investigate complaints made by patient Element
▼ 367323 Interim Healthcare Of Columbus 2682 North Columbus Street, Suite A Lancaster OH 5 (Chicago) 10/25/2018 TDEW11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0700 Skilled professional services Condition
G0578 Conformance with physician orders Standard
G0580 Only as ordered by a physician Element
G0710 Provide services in the plan of care Element
G0716 Preparing clinical notes Element
G0808 Onsite supervisory visit every 14 days Element
▼ 367329 Home Care Network Inc 731 East Main Street, Suite 17c Jackson OH 5 (Chicago) 02/07/2023 5EEAE-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G1026 Retention of records Standard