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
▼ 377712 Ok4 Home Health Agency, Llc 2303 S York Street Muskogee OK 6 (Dallas) 05/09/2019 IGWZ11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0574 Plan of care must include the following Element
G0808 Onsite supervisory visit every 14 days Element
G1012 Required items in clinical record Element
▼ 377713 Homecare Clinicians, Llc 103 N Walnut Street, Suite A Sallisaw OK 6 (Dallas) 01/19/2024 61FF4-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
G0702 Services by skilled professionals Standard
G0520 5 calendar days after start of care Element
G0536 A review of all current medications Element
▼ 377714 Ross Home Health Of Enid, Llc 2613 N Van Buren St., Ste 102 Enid OK 6 (Dallas) 04/23/2025 66015-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0514 RN performs assessment Element
G0574 Plan of care must include the following Element
G0602 Communication with all physicians Element
G1022 Discharge and transfer summaries Element
▼ 377714 Ross Home Health Of Enid, Llc 2613 N Van Buren St., Ste 102 Enid OK 6 (Dallas) 06/28/2022 4EF42-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
G0942 Governing body Standard
G0580 Only as ordered by a physician Element
G0710 Provide services in the plan of care Element
G1022 Discharge and transfer summaries Element
▼ 377715 Ahni Health Services Inc. 119 Sw Main Keota OK 6 (Dallas) 08/13/2024 63E7C-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0644 Program data Standard
G0658 Performance improvement projects Standard
G0574 Plan of care must include the following Element
G0590 Promptly alert relevant physician of changes Element
▼ 377715 Ahni Health Services Inc. 119 Sw Main Keota OK 6 (Dallas) 08/17/2021 Q0JT11 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
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0710 Provide services in the plan of care Element
G1022 Discharge and transfer summaries Element
▼ 377715 Ahni Health Services Inc. 119 Sw Main Keota OK 6 (Dallas) 10/24/2018 76WF11 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
G0578 Conformance with physician orders Standard
G0642 Program scope Standard
G0644 Program data Standard
G0654 Track adverse patient events Standard
G0658 Performance improvement projects Standard
G0660 Executive responsibilities for QAPI Standard
G0648 High risk, high volume, or problem-prone area Element
G0652 Activities lead to an immediate correction Element
G0656 Improvements are sustained Element
▼ 377717 Phoenix Home Health Agency, Llc 2526 North Midwest Boulevard Spencer OK 6 (Dallas) 01/07/2025 651B4-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0036 EP Training and Testing Standard
E0039 EP Testing Requirements Standard
G0644 Program data Standard
G0646 Program activities Standard
G0660 Executive responsibilities for QAPI Standard
G0684 Infection control Standard
G0942 Governing body Standard
G0456 Patient/payer will no longer pay for services Element
G0574 Plan of care must include the following Element
G0576 All orders recorded in plan of care Element
G0710 Provide services in the plan of care Element
G0716 Preparing clinical notes Element
G0720 Participate in the HHA's QAPI program; Element
G1014 Interventions and patient response Element
G1022 Discharge and transfer summaries Element
▼ 377717 Phoenix Home Health Agency, Llc 2526 North Midwest Boulevard Spencer OK 6 (Dallas) 02/14/2022 38528-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
G0656 Improvements are sustained Element
▼ 377717 Phoenix Home Health Agency, Llc 2526 North Midwest Boulevard Spencer OK 6 (Dallas) 02/01/2019 L31I11 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