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
▼ 377568 Indian Territory Home Health & Hospice I, Llc 2020 Arlington Road, Suite 5 Ada OK 6 (Dallas) 10/10/2024 646BB-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0006 Plan Based on All Hazards Risk Assessment Standard
E0007 EP Program Patient Population Standard
G0574 Plan of care must include the following Element
G0580 Only as ordered by a physician Element
G0608 Coordinate care delivery Element
▼ 377568 Indian Territory Home Health & Hospice I, Llc 2020 Arlington Road, Suite 5 Ada OK 6 (Dallas) 10/06/2021 Q47G11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0578 Conformance with physician orders Standard
G0710 Provide services in the plan of care Element
▼ 377569 A Path Of Care Home Health Vii, Llc 110 E Franklin St, Ste 100 Weatherford OK 6 (Dallas) 06/06/2024 63547-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0658 Performance improvement projects Standard
G0946 Administrator appointed by governing body Element
▼ 377569 A Path Of Care Home Health Vii, Llc 110 E Franklin St, Ste 100 Weatherford OK 6 (Dallas) 10/18/2018 X3HU11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0658 Performance improvement projects Standard
G0590 Promptly alert relevant physician of changes Element
G0718 Communication with physicians Element
▼ 377572 Day-By-Day Staff Relief, Llc 1913 West Tacoma Street, Suite G-H Broken Arrow OK 6 (Dallas) 06/02/2022 4ECA6-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0600 Coordination of Care Standard
G0456 Patient/payer will no longer pay for services Element
G0710 Provide services in the plan of care Element
G0808 Onsite supervisory visit every 14 days Element
▼ 377572 Day-By-Day Staff Relief, Llc 1913 West Tacoma Street, Suite G-H Broken Arrow OK 6 (Dallas) 05/29/2019 QK1H11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0476 Investigation of complaints Standard
G0942 Governing body Standard
G0614 Visit schedule Element
▼ 377572 Day-By-Day Staff Relief, Llc 1913 West Tacoma Street, Suite G-H Broken Arrow OK 6 (Dallas) 08/29/2018 RWG211 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0484 Document complaint and resolution Element
▼ 377574 Victory Home Health, Llc 750 East Main Tishomingo OK 6 (Dallas) 12/06/2023 61AE6-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0578 Conformance with physician orders Standard
G0600 Coordination of Care Standard
G1024 Authentication Standard
G0962 Coordinate patient care Element
▼ 377574 Victory Home Health, Llc 750 East Main Tishomingo OK 6 (Dallas) 11/13/2020 PCU311 Complaint, Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0640 Quality assessment/performance improvement Condition
E0039 EP Testing Requirements Standard
G0578 Conformance with physician orders Standard
G0642 Program scope Standard
G0644 Program data Standard
G0658 Performance improvement projects Standard
G0660 Executive responsibilities for QAPI Standard
G0684 Infection control Standard
G0942 Governing body Standard
G0514 RN performs assessment Element
G0574 Plan of care must include the following Element
▼ 377580 Hometown Home Heath, Llc 7512 N. Broadway Ext., Ste 312 E Oklahoma City OK 6 (Dallas) 11/30/2023 61A2E-H1 Complaint, Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0578 Conformance with physician orders Standard