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
▼ 377665 Gentle Shepherd Home Health, Incorporated 2216 Shadow Lake Dr Oklahoma City OK 6 (Dallas) 01/04/2024 61E8F-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
E0009 Local, State, Tribal Collaboration Process Standard
E0030 Names and Contact Information Standard
G0642 Program scope Standard
G0658 Performance improvement projects Standard
G0942 Governing body Standard
G0460 Patient refuses services Element
G0484 Document complaint and resolution Element
G0574 Plan of care must include the following Element
G0576 All orders recorded in plan of care Element
G0580 Only as ordered by a physician Element
G0608 Coordinate care delivery Element
G0720 Participate in the HHA's QAPI program; Element
G0808 Onsite supervisory visit every 14 days Element
G1014 Interventions and patient response Element
G1022 Discharge and transfer summaries Element
▼ 377665 Gentle Shepherd Home Health, Incorporated 2216 Shadow Lake Dr Oklahoma City OK 6 (Dallas) 02/11/2021 55MW11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0942 Governing body Standard
G0580 Only as ordered by a physician Element
G0590 Promptly alert relevant physician of changes Element
G1022 Discharge and transfer summaries Element
▼ 377665 Gentle Shepherd Home Health, Incorporated 2216 Shadow Lake Dr Oklahoma City OK 6 (Dallas) 03/08/2018 DU4211 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0710 Provide services in the plan of care Element
G0716 Preparing clinical notes Element
▼ 377667 Indian Territory Home Health And Hospice Iii, Llc 4815 S Harvard, Suite 300 Tulsa OK 6 (Dallas) 11/19/2025 1DC4C1-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0456 Patient/payer will no longer pay for services Element
G0574 Plan of care must include the following Element
G0602 Communication with all physicians Element
G0710 Provide services in the plan of care Element
G1012 Required items in clinical record Element
G1014 Interventions and patient response Element
▼ 377667 Indian Territory Home Health And Hospice Iii, Llc 4815 S Harvard, Suite 300 Tulsa OK 6 (Dallas) 09/01/2022 4F587-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
G0574 Plan of care must include the following Element
▼ 377668 Universal Rehab Services, Llc 114 Nw 6th Street, Suite 104 Oklahoma City OK 6 (Dallas) 05/23/2025 66469-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0684 Infection control Standard
G0442 Written notice for non-covered care Element
G0454 HHA can no longer meet the patient's needs Element
G0514 RN performs assessment Element
G0548 Within 48 hours of the patient's return Element
G0602 Communication with all physicians Element
G0720 Participate in the HHA's QAPI program; Element
G0728 Rehab services supervised by PT, OT Element
G1022 Discharge and transfer summaries Element
▼ 377668 Universal Rehab Services, Llc 114 Nw 6th Street, Suite 104 Oklahoma City OK 6 (Dallas) 07/20/2022 4F14E-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
G0572 Plan of care Standard
G0644 Program data Standard
G0646 Program activities Standard
G0684 Infection control Standard
G0514 RN performs assessment Element
G0520 5 calendar days after start of care Element
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G1022 Discharge and transfer summaries Element
▼ 377668 Universal Rehab Services, Llc 114 Nw 6th Street, Suite 104 Oklahoma City OK 6 (Dallas) 08/13/2019 IJXO11 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
G0536 A review of all current medications Element
G0614 Visit schedule Element
▼ 377669 A Path Of Care Home Health Vi, Llc 6202 Nw Oak Ave Lawton OK 6 (Dallas) 05/13/2026 232271-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0031 Emergency Officials Contact Information Standard
G0514 RN performs assessment Element
G0608 Coordinate care delivery Element
G0808 Onsite supervisory visit every 14 days Element
▼ 377669 A Path Of Care Home Health Vi, Llc 6202 Nw Oak Ave Lawton OK 6 (Dallas) 05/09/2023 5FC51-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
E0009 Local, State, Tribal Collaboration Process Standard
E0030 Names and Contact Information Standard
G0564 Discharge or Transfer Summary Content Standard
G0572 Plan of care Standard
G0942 Governing body Standard
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0720 Participate in the HHA's QAPI program; Element