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
▼ 368103 Zimam Holdings, Llc 415 East Mound Street Columbus OH 5 (Chicago) 04/17/2019 3NQ611 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0036 EP Training and Testing Standard
E0039 EP Testing Requirements Standard
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
▼ 368104 Pf Development 15, Llc 31225 Bainbridge Road, Suite I Solon OH 5 (Chicago) 08/01/2019 CBVL11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0940 Organization and administration of services Condition
G0572 Plan of care Standard
G0952 Ensure that HHA employs qualified personnel Element
G0974 Direct support and administrative control Element
▼ 368104 Pf Development 15, Llc 31225 Bainbridge Road, Suite I Solon OH 5 (Chicago) 08/23/2018 6QRT11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
▼ 368104 Pf Development 15, Llc 31225 Bainbridge Road, Suite I Solon OH 5 (Chicago) 02/01/2018 9OU511 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
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
G0536 A review of all current medications Element
▼ 368106 Valley Home Health Care, Llc 755 Boardman Canfield Road, Suite N1 Boardman OH 5 (Chicago) 01/04/2018 JZ8H11 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
E0004 Develop EP Plan, Review and Update Annually Standard
E0009 Local, State, Tribal Collaboration Process Standard
E0013 Development of EP Policies and Procedures Standard
E0021 HHA- Procedures for Follow up Staff/Pts. Standard
E0029 Development of Communication Plan Standard
E0031 Emergency Officials Contact Information Standard
E0032 Primary/Alternate Means for Communication Standard
E0036 EP Training and Testing Standard
E0039 EP Testing Requirements Standard
G0158 ACCEPTANCE OF PATIENTS, POC, MED SUPER Standard
G0159 PLAN OF CARE Standard
G0229 SUPERVISION Standard
▼ 368108 Phoenix Home Health Care Of Central Ohio Llc 30 Northwoods Blvd, Suite 200 Columbus OH 5 (Chicago) 03/21/2018 HSJ311 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
▼ 368109 America's Home Health Services, Llc 3556 Sullivant Avenue, Suite 205 Columbus OH 5 (Chicago) 08/01/2018 JLTY11 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
▼ 368112 New Millenium Home Health, Llc 6031 Cleveland Avenue Columbus OH 5 (Chicago) 11/16/2021 37E94-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0702 Services by skilled professionals Standard
▼ 368112 New Millenium Home Health, Llc 6031 Cleveland Avenue Columbus OH 5 (Chicago) 09/27/2018 8ICW11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0546 Last 5 days of every 60 days unless: Element
G0580 Only as ordered by a physician Element
G0710 Provide services in the plan of care Element
▼ 368114 A M Friends & Family Healthcare, Llc 2211 Lake Club Drive, Suite 200 Columbus OH 5 (Chicago) 01/31/2019 47ZI11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0574 Plan of care must include the following Element
G0592 Revised plan of care Element
G0800 Services provided by HH aide Element