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
▼ 368250 Altimate Care, Llc 20515 Shaker Blvd. Shaker Heights OH 5 (Chicago) 10/14/2021 19740-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0570 Care planning, coordination, quality of care Condition
G0940 Organization and administration of services Condition
G0590 Promptly alert relevant physician of changes Element
G0974 Direct support and administrative control Element
▼ 368250 Altimate Care, Llc 20515 Shaker Blvd. Shaker Heights OH 5 (Chicago) 06/10/2021 Y9NZ11 Focused Infection Control, Other-Fed, 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
G0710 Provide services in the plan of care Element
▼ 368250 Altimate Care, Llc 20515 Shaker Blvd. Shaker Heights OH 5 (Chicago) 12/10/2020 CQEG11 Complaint, Focused Infection Control, Other-Fed
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0480 Treatment or care Element
▼ 368250 Altimate Care, Llc 20515 Shaker Blvd. Shaker Heights OH 5 (Chicago) 10/22/2020 B1QL11 Complaint, Focused Infection Control, Other-Fed
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0940 Organization and administration of services Condition
G0710 Provide services in the plan of care Element
G0972 Report all branch locations to SA Element
▼ 368254 Homecare Network Of Ohio, Inc 7000 State Route 88 Ravenna OH 5 (Chicago) 01/31/2018 YGQE11 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
E0042 Integrated EP Program Standard
G0710 Provide services in the plan of care Element
▼ 368255 Buckeye Health Agency Llc 6040 Cleveland Ave Columbus OH 5 (Chicago) 05/11/2022 38A5E-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0680 Infection prevention and control Condition
G0687 COVID-19 Vaccination of Home Health Agency staff Standard
▼ 368255 Buckeye Health Agency Llc 6040 Cleveland Ave Columbus OH 5 (Chicago) 04/18/2019 RR2T11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0800 Services provided by HH aide Element
▼ 368255 Buckeye Health Agency Llc 6040 Cleveland Ave Columbus OH 5 (Chicago) 03/14/2018 4M1R11 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
▼ 368256 Haven Skilled Care Of Canton, Llc 150 North Miller Road, Suite 350a Fairlawn OH 5 (Chicago) 02/08/2018 TEWO11 Recertification, Sample Validation
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
E0006 Plan Based on All Hazards Risk Assessment Standard
E0007 EP Program Patient Population Standard
E0009 Local, State, Tribal Collaboration Process Standard
E0013 Development of EP Policies and Procedures 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
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
E0036 EP Training and Testing Standard
E0037 EP Training Program Standard
E0039 EP Testing Requirements Standard
G0572 Plan of care Standard
G0702 Services by skilled professionals Standard
G0514 RN performs assessment Element
G0536 A review of all current medications Element
G0580 Only as ordered by a physician Element
G0710 Provide services in the plan of care Element
▼ 368257 Care4me Skilled, Llc 2400 Southeast Blvd, Suite B Salem OH 5 (Chicago) 06/21/2018 5FJB11 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
G0570 Care planning, coordination, quality of care Condition
G0640 Quality assessment/performance improvement Condition
G0572 Plan of care Standard
G0642 Program scope Standard
G0644 Program data Standard
G0768 Competency evaluation Standard
G0798 Home health aide assignments and duties Standard
G0514 RN performs assessment Element
G0546 Last 5 days of every 60 days unless: Element
G0574 Plan of care must include the following Element
G0588 Reviewed, revised by physician every 60 days Element
G0726 Nursing services supervised by RN Element
G0800 Services provided by HH aide Element
G0814 Non-skilled direct observation every 60 days Element
G0946 Administrator appointed by governing body Element
G0954 Ensures qualified pre-designated person Element