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
▼ 368473 America's Home Health Agency, Llc 1336 East Main Street, Unit G Columbus OH 5 (Chicago) 04/12/2018 COQA11 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
E0019 Homebound HHA/Hospice Inform EP Officials 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
G0572 Plan of care Standard
G0574 Plan of care must include the following Element
G0580 Only as ordered by a physician Element
G0706 Interdisciplinary assessment of the patient Element
G0710 Provide services in the plan of care Element
G0808 Onsite supervisory visit every 14 days Element
G0814 Non-skilled direct observation every 60 days Element
▼ 368479 American Institute Of Medical Solutions, Llc 3721 N Main Street Dayton OH 5 (Chicago) 04/05/2022 387D1-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0680 Infection prevention and control Condition
G0687 COVID-19 Vaccination of Home Health Agency staff Standard
▼ 368479 American Institute Of Medical Solutions, Llc 3721 N Main Street Dayton OH 5 (Chicago) 12/28/2018 O13B11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0614 Visit schedule Element
▼ 368480 Ivory Home Health Services Inc 6488 E Main St, Suite C Reynoldsburg OH 5 (Chicago) 03/13/2019 VMRT11 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
▼ 368482 Legacy Visiting Health Services 3660 Starrs Centre Drive, Unit A Canfield OH 5 (Chicago) 02/13/2025 6548A-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0372 Encoding and transmitting OASIS Standard
G0642 Program scope Standard
G0416 OASIS privacy notice Element
G0800 Services provided by HH aide Element
▼ 368483 Great Home Healthcare, Llc 2999 East Dublin Granville Road, Suite 215 Columbus OH 5 (Chicago) 03/12/2020 PJQD11 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
▼ 368486 Premium Healthcare Services Llc 2242 S Hamilton Road, Suite 100 Columbus OH 5 (Chicago) 01/16/2019 097611 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
E0009 Local, State, Tribal Collaboration Process Standard
E0013 Development of EP Policies and Procedures Standard
E0029 Development of Communication Plan Standard
E0036 EP Training and Testing Standard
E0039 EP Testing Requirements Standard
G0572 Plan of care Standard
G0574 Plan of care must include the following Element
▼ 368487 Selective Nursing Llc 2107 Jergens Road Dayton OH 5 (Chicago) 09/05/2019 HDUT11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0596 Revisions communicated to patient and MDs Element
▼ 368489 1 Amazing Home Health Care Llc 5898 Cleveland Avenue, Lower Level Columbus OH 5 (Chicago) 07/18/2024 63960-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0570 Care planning, coordination, quality of care Condition
G0572 Plan of care Standard
G0464 Advise the patient of discharge for cause Element
G0576 All orders recorded in plan of care Element
▼ 368489 1 Amazing Home Health Care Llc 5898 Cleveland Avenue, Lower Level Columbus OH 5 (Chicago) 04/07/2022 386FE-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard