S&C QCOR HHA 2567s
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HHAs 2567s
Selection Criteria ▸

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
▼ 369006 Moonlight Home Health Care Inc 102 Javit Court Youngstown OH 5 (Chicago) 03/19/2024 627DD-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0940 Organization and administration of services Condition
G0948 Responsible for all day-to-day operations Element
▼ 369006 Moonlight Home Health Care Inc 102 Javit Court Youngstown OH 5 (Chicago) 02/06/2024 6209C-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0640 Quality assessment/performance improvement Condition
G0750 Home health aide services Condition
G0940 Organization and administration of services Condition
G0768 Competency evaluation Standard
G0774 12 hours inservice every 12 months Standard
G0798 Home health aide assignments and duties Standard
G0942 Governing body Standard
G0754 A qualified HH aide successfully completed: Element
G0946 Administrator appointed by governing body Element
G0974 Direct support and administrative control Element
▼ 369006 Moonlight Home Health Care Inc 102 Javit Court Youngstown OH 5 (Chicago) 12/20/2023 61B14-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0478 Investigate complaints made by patient Element
G0580 Only as ordered by a physician Element
G0754 A qualified HH aide successfully completed: Element
G0952 Ensure that HHA employs qualified personnel Element
G0972 Report all branch locations to SA Element
▼ 369006 Moonlight Home Health Care Inc 102 Javit Court Youngstown OH 5 (Chicago) 07/20/2023 606BF-H1 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
▼ 369006 Moonlight Home Health Care Inc 102 Javit Court Youngstown OH 5 (Chicago) 03/30/2023 5F420-H1 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
▼ 369006 Moonlight Home Health Care Inc 102 Javit Court Youngstown OH 5 (Chicago) 01/09/2023 5EA9E-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0484 Document complaint and resolution Element
▼ 369006 Moonlight Home Health Care Inc 102 Javit Court Youngstown OH 5 (Chicago) 10/04/2022 5D846-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0750 Home health aide services Condition
G0572 Plan of care Standard
G0782 Eligible training/competency evaluation orgs. Standard
G0484 Document complaint and resolution Element
G0514 RN performs assessment Element
G0574 Plan of care must include the following Element
G0800 Services provided by HH aide Element
G0814 Non-skilled direct observation every 60 days Element
G0952 Ensure that HHA employs qualified personnel Element
G0972 Report all branch locations to SA Element
▼ 369006 Moonlight Home Health Care Inc 102 Javit Court Youngstown OH 5 (Chicago) 02/09/2021 4I7U11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0972 Report all branch locations to SA Element
▼ 369006 Moonlight Home Health Care Inc 102 Javit Court Youngstown OH 5 (Chicago) 10/15/2020 9U7G11 Complaint, Focused Infection Control, Other-Fed
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0570 Care planning, coordination, quality of care Condition
G0680 Infection prevention and control Condition
G0572 Plan of care Standard
G0684 Infection control Standard
▼ 369006 Moonlight Home Health Care Inc 102 Javit Court Youngstown OH 5 (Chicago) 02/06/2019 8Y9U11 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
E0039 EP Testing Requirements Standard
G0536 A review of all current medications Element
G0800 Services provided by HH aide Element