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
▼ 368021 Serenity Home Health Care Services, Llc 800 Freeway Drive N., Suite #100 Columbus OH 5 (Chicago) 03/17/2021 12ZH11 Complaint, Focused Infection Control, Other-Fed
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0800 Services provided by HH aide Element
▼ 368021 Serenity Home Health Care Services, Llc 800 Freeway Drive N., Suite #100 Columbus OH 5 (Chicago) 03/01/2018 HD4211 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0702 Services by skilled professionals Standard
▼ 368025 Seasons Of Care Health Services, Llc 18051 Jefferson Park Road Middleburg Heights OH 5 (Chicago) 08/17/2023 60B9B-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
E0036 EP Training and Testing Standard
G0572 Plan of care Standard
G0536 A review of all current medications Element
▼ 368034 Home Care Network, Inc 134 West South Boundary Street, Suite G-2 Perrysburg OH 5 (Chicago) 05/30/2025 663C7-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0724 Supervise skilled professional assistants Standard
G0542 Incorporate OASIS items Element
G0814 Non-skilled direct observation every 60 days Element
▼ 368035 Diamonds & Pearls Health Services Llc 23811 Chagrin Blvd, Suite 160 Beachwood OH 5 (Chicago) 02/13/2019 0QT411 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
E0006 Plan Based on All Hazards Risk Assessment Standard
E0009 Local, State, Tribal Collaboration Process Standard
E0017 HHA Comprehensive Assessment in Disaster Standard
E0019 Homebound HHA/Hospice Inform EP Officials Standard
E0021 HHA- Procedures for Follow up Staff/Pts. Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0029 Development of Communication Plan Standard
E0037 EP Training Program Standard
E0039 EP Testing Requirements Standard
G0574 Plan of care must include the following Element
G0576 All orders recorded in plan of care Element
▼ 368036 The Sun Home Health Care, Inc 554 West Central Avenue, Unit 5-6 Delaware OH 5 (Chicago) 04/03/2019 6MBW11 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
E0039 EP Testing Requirements Standard
G0814 Non-skilled direct observation every 60 days Element
G1022 Discharge and transfer summaries Element
▼ 368037 Independent Home Care, Inc 4371 East Broad Street, Suite 101 Columbus OH 5 (Chicago) 06/05/2019 DTL711 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0478 Investigate complaints made by patient Element
▼ 368038 Pinnacle Home Health Care Agency, Inc 3045 Rodenbeck Drive Beaver Creek OH 5 (Chicago) 02/07/2018 JE6611 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0590 Promptly alert relevant physician of changes Element
▼ 368039 Able Support Services, Inc 2931 E. Dublin Granville Road, Suite 190 Columbus OH 5 (Chicago) 01/04/2018 D96K11 Complaint, Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0323 TRANSMITTAL OF OASIS DATA Standard
G0337 DRUG REGIMEN REVIEW Standard
▼ 368042 Maxim Healthcare Services, Inc 110 West Western Reserve Road Poland OH 5 (Chicago) 01/12/2023 5E7B3-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
G0574 Plan of care must include the following Element