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
▼ 367329 Home Care Network Inc 731 East Main Street, Suite 17c Jackson OH 5 (Chicago) 03/14/2018 8OF111 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0798 Home health aide assignments and duties Standard
G1010 Contents of clinical record Standard
▼ 367335 Home Care Network, Inc 731 East Main Street, Suite 17a Jackson OH 5 (Chicago) 02/21/2019 GPK211 Complaint, Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
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
G0800 Services provided by HH aide Element
G0804 Aides are members of interdisciplinary team Element
▼ 367336 Home Care Network, Inc. 731 E Main Street, Suite 17d Jackson OH 5 (Chicago) 08/11/2022 4F2AB-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0536 A review of all current medications Element
▼ 367336 Home Care Network, Inc. 731 E Main Street, Suite 17d Jackson OH 5 (Chicago) 02/22/2018 L63U11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0376 Transmittal of OASIS data Standard
▼ 367337 Rx Home Healthcare, Inc 1000 East Broad Street, 2nd Floor Columbus OH 5 (Chicago) 02/01/2018 ZV3K11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0001 Establishment of the Emergency Program (EP) Condition
G0640 Quality assessment/performance improvement Condition
G0940 Organization and administration of services Condition
E0004 Develop EP Plan, Review and Update Annually Standard
E0006 Plan Based on All Hazards Risk Assessment Standard
E0029 Development of Communication Plan Standard
E0037 EP Training Program Standard
E0039 EP Testing Requirements Standard
G0642 Program scope Standard
G0660 Executive responsibilities for QAPI Standard
G0942 Governing body Standard
G0988 Institutional planning Standard
G0946 Administrator appointed by governing body Element
G0954 Ensures qualified pre-designated person Element
▼ 367401 Lima Memorial Joint Operating Company 1301 Bellefontaine Avenue Lima OH 5 (Chicago) 05/10/2018 6BMD11 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
G0606 Integrate all services Element
▼ 367415 University Hospitals Home Care Services, Inc 663 East Main Street Ashland OH 5 (Chicago) 02/17/2022 3848C-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
▼ 367423 Lake Hospital System, Inc 9485 Mentor Avenue Mentor OH 5 (Chicago) 01/30/2020 2TGF11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0578 Conformance with physician orders Standard
G0608 Coordinate care delivery Element
▼ 367433 Southeastern Home Care, Llc 1225 Woodlawn Avenue, Suite 113 Cambridge OH 5 (Chicago) 05/18/2023 5FCD3-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0536 A review of all current medications Element
▼ 367442 Stonerise Reliable Healthcare, Llc 187 West Main Street, Suite 200 Saint Clairsville OH 5 (Chicago) 07/20/2023 606AF-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
G0536 A review of all current medications Element
G0716 Preparing clinical notes Element
G0800 Services provided by HH aide Element
G0808 Onsite supervisory visit every 14 days Element