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
▼ 367571 Hallmark Home Care Inc 1220 Gay Street Portsmouth OH 5 (Chicago) 01/23/2020 JGGM11 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
▼ 367571 Hallmark Home Care Inc 1220 Gay Street Portsmouth OH 5 (Chicago) 05/08/2019 E4NI11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0484 Document complaint and resolution Element
G0706 Interdisciplinary assessment of the patient Element
▼ 367573 American Nursing Care, Inc 1206 A Brandywine Blvd Zanesville OH 5 (Chicago) 10/31/2019 76S511 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
G0536 A review of all current medications Element
▼ 367576 Tlc Complete Home Care Inc 43 Kennedy Drive Caldwell OH 5 (Chicago) 08/04/2020 65ZW11 Complaint, Focused Infection Control, Other-Fed
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0544 Update of the comprehensive assessment Standard
G0686 Infection control education Standard
▼ 367576 Tlc Complete Home Care Inc 43 Kennedy Drive Caldwell OH 5 (Chicago) 11/20/2018 002V11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0710 Provide services in the plan of care Element
▼ 367582 Home Health Care By Black Stone Of Northwest Ohio, Llc 7015 Spring Meadows West Drive, Suite 102 Holland OH 5 (Chicago) 12/18/2018 8EJI11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0710 Provide services in the plan of care Element
▼ 367582 Home Health Care By Black Stone Of Northwest Ohio, Llc 7015 Spring Meadows West Drive, Suite 102 Holland OH 5 (Chicago) 07/17/2018 ZXGC11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0804 Aides are members of interdisciplinary team Element
▼ 367587 Hhcs, Inc 2615 Ft Amanda Road Lima OH 5 (Chicago) 08/26/2022 4F423-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0570 Care planning, coordination, quality of care Condition
G0940 Organization and administration of services Condition
G0572 Plan of care Standard
G0682 Infection Prevention Standard
G0684 Infection control Standard
G0942 Governing body Standard
G0988 Institutional planning Standard
G0574 Plan of care must include the following Element
G0576 All orders recorded in plan of care Element
G0590 Promptly alert relevant physician of changes Element
G0808 Onsite supervisory visit every 14 days Element
G0946 Administrator appointed by governing body Element
G0948 Responsible for all day-to-day operations Element
G0952 Ensure that HHA employs qualified personnel Element
G0954 Ensures qualified pre-designated person Element
G0974 Direct support and administrative control Element
▼ 367587 Hhcs, Inc 2615 Ft Amanda Road Lima OH 5 (Chicago) 12/26/2019 H8V711 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0580 Only as ordered by a physician Element
G0808 Onsite supervisory visit every 14 days Element
▼ 367592 Nuvantage Healthcare Corporation 8857 Cincinnati Dayton Road, Suite 101 West Chester OH 5 (Chicago) 10/13/2021 19749-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0578 Conformance with physician orders Standard
G0574 Plan of care must include the following Element