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
▼ 368334 Liberty Healthcare Services, Llc 123 South Broad Street, Suite 305 Lancaster OH 5 (Chicago) 04/24/2024 62DB3-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0574 Plan of care must include the following Element
G0580 Only as ordered by a physician Element
▼ 368334 Liberty Healthcare Services, Llc 123 South Broad Street, Suite 305 Lancaster OH 5 (Chicago) 01/30/2024 61FB0-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0478 Investigate complaints made by patient Element
G0574 Plan of care must include the following Element
G0580 Only as ordered by a physician Element
▼ 368334 Liberty Healthcare Services, Llc 123 South Broad Street, Suite 305 Lancaster OH 5 (Chicago) 10/03/2019 VDFO11 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
G0640 Quality assessment/performance improvement Condition
G0680 Infection prevention and control Condition
G0940 Organization and administration of services Condition
G0642 Program scope Standard
G0684 Infection control Standard
G0942 Governing body Standard
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0576 All orders recorded in plan of care Element
G0808 Onsite supervisory visit every 14 days Element
▼ 368335 Prime Home Care, Llc 1105 Schrock Rd, Suite 208 Columbus OH 5 (Chicago) 03/22/2024 627E5-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0484 Document complaint and resolution Element
▼ 368335 Prime Home Care, Llc 1105 Schrock Rd, Suite 208 Columbus OH 5 (Chicago) 10/14/2021 19748-H1 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
G0580 Only as ordered by a physician Element
G0972 Report all branch locations to SA Element
▼ 368336 Excel Home Health Plus, Llc 470 Olde Worthington Road Suite 200 Westerville OH 5 (Chicago) 05/16/2018 25WY11 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
G0580 Only as ordered by a physician Element
▼ 368340 Horizon Healthcare Services, Llc 2999 East Dublin Granville Road, Suite 106 Columbus OH 5 (Chicago) 07/30/2024 63A79-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0514 RN performs assessment Element
G0580 Only as ordered by a physician Element
▼ 368340 Horizon Healthcare Services, Llc 2999 East Dublin Granville Road, Suite 106 Columbus OH 5 (Chicago) 07/20/2022 4F0E5-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0580 Only as ordered by a physician Element
G0808 Onsite supervisory visit every 14 days Element
▼ 368340 Horizon Healthcare Services, Llc 2999 East Dublin Granville Road, Suite 106 Columbus OH 5 (Chicago) 12/10/2020 JPGG11 Complaint, Focused Infection Control, Other-Fed
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0434 Participate in care Element
▼ 368340 Horizon Healthcare Services, Llc 2999 East Dublin Granville Road, Suite 106 Columbus OH 5 (Chicago) 07/11/2019 8N1X11 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
E0019 Homebound HHA/Hospice Inform EP Officials Standard
E0021 HHA- Procedures for Follow up Staff/Pts. Standard
E0029 Development of Communication Plan Standard
E0032 Primary/Alternate Means for Communication Standard
E0037 EP Training Program Standard
G0572 Plan of care Standard
G0460 Patient refuses services Element
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0580 Only as ordered by a physician Element