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
▼ 368042 Maxim Healthcare Services, Inc 110 West Western Reserve Road Poland OH 5 (Chicago) 06/07/2018 1DZZ11 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
▼ 368043 J&J's Consulting And Home Health, Llc 1418 Brice Road, Suite 205 Reynoldsburg OH 5 (Chicago) 02/06/2020 S2YP11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0039 EP Testing Requirements Standard
▼ 368044 Excel Health Services, Llc 4889 Sinclair Road, Suite 115 Columbus OH 5 (Chicago) 03/06/2019 LV5C11 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
G0576 All orders recorded in plan of care Element
G0800 Services provided by HH aide Element
G0808 Onsite supervisory visit every 14 days Element
G0948 Responsible for all day-to-day operations Element
▼ 368045 Avidity Home Care, Inc 27801 Euclid Avenue, Suite 300 Euclid OH 5 (Chicago) 05/30/2018 97QS11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0578 Conformance with physician orders Standard
▼ 368045 Avidity Home Care, Inc 27801 Euclid Avenue, Suite 300 Euclid OH 5 (Chicago) 03/01/2018 X8LY11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0800 Services provided by HH aide Element
G0814 Non-skilled direct observation every 60 days Element
▼ 368045 Avidity Home Care, Inc 27801 Euclid Avenue, Suite 300 Euclid OH 5 (Chicago) 01/18/2018 NO1111 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
G0510 Comprehensive Assessment of Patients 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
E0007 EP Program Patient Population 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
E0023 Policies/Procedures for Medical Documentation Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0029 Development of Communication Plan Standard
E0030 Names and Contact Information Standard
E0031 Emergency Officials Contact Information Standard
E0032 Primary/Alternate Means for Communication Standard
E0033 Methods for Sharing Information Standard
E0034 Information on Occupancy/Needs Standard
E0036 EP Training and Testing Standard
E0037 EP Training Program Standard
E0039 EP Testing Requirements Standard
G0372 Encoding and transmitting OASIS Standard
G0768 Competency evaluation Standard
G0536 A review of all current medications Element
G0550 At discharge Element
G0574 Plan of care must include the following Element
G0706 Interdisciplinary assessment of the patient Element
G0710 Provide services in the plan of care Element
G0714 Patient and caregiver education Element
G0800 Services provided by HH aide Element
G0948 Responsible for all day-to-day operations Element
G0952 Ensure that HHA employs qualified personnel Element
▼ 368047 Homesite Home Health Care, Llc 4800 Urbana Road, Suite 103 Springfield OH 5 (Chicago) 08/01/2019 O6GI11 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
▼ 368049 Omnicare Home Healthcare Agency, Llc 23611 Chagrin Blvd, Suite 120 Beachwood OH 5 (Chicago) 07/20/2022 4F094-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0468 Provide contact info other services Element
G0470 Document efforts to resolve problems Element
▼ 368049 Omnicare Home Healthcare Agency, Llc 23611 Chagrin Blvd, Suite 120 Beachwood OH 5 (Chicago) 09/18/2019 3C3X11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0940 Organization and administration of services Condition
G0958 Clinical manager Standard
G0546 Last 5 days of every 60 days unless: Element
G0580 Only as ordered by a physician Element
G0814 Non-skilled direct observation every 60 days Element
G0950 Ensure clinical manager is available Element
G0954 Ensures qualified pre-designated person Element
G0966 Assure patient needs are continually assessed Element
▼ 368049 Omnicare Home Healthcare Agency, Llc 23611 Chagrin Blvd, Suite 120 Beachwood OH 5 (Chicago) 01/30/2019 OFTO11 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