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
▼ 058406 Patients First Home Health Agency, Inc 23210 S Crenshaw Blvd, Suite 200 Torrance CA 9 (San Francisco) 01/29/2023 5EDC4-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
G0526 Content of the comprehensive assessment Standard
G0600 Coordination of Care Standard
G0658 Performance improvement projects Standard
G0444 State toll free HH telephone hotline Element
G0532 Continuing need for home care Element
G0536 A review of all current medications Element
G0590 Promptly alert relevant physician of changes Element
▼ 058406 Patients First Home Health Agency, Inc 23210 S Crenshaw Blvd, Suite 200 Torrance CA 9 (San Francisco) 07/08/2019 BCN011 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0574 Plan of care must include the following Element
G0618 Treatments and therapy services Element
G0710 Provide services in the plan of care Element
▼ 058408 Green Pine Home Healthcare Services, Inc 1740 New Avenue Suite 101,103,110 San Gabriel CA 9 (San Francisco) 05/06/2022 38A0E-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0510 Comprehensive Assessment of Patients Condition
G0570 Care planning, coordination, quality of care Condition
G0700 Skilled professional services Condition
G0526 Content of the comprehensive assessment Standard
G0536 A review of all current medications Element
G0580 Only as ordered by a physician Element
G0592 Revised plan of care Element
G0714 Patient and caregiver education Element
G0718 Communication with physicians Element
G1012 Required items in clinical record Element
▼ 058408 Green Pine Home Healthcare Services, Inc 1740 New Avenue Suite 101,103,110 San Gabriel CA 9 (San Francisco) 02/01/2019 6QB111 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0642 Program scope Standard
G0658 Performance improvement projects Standard
G1024 Authentication Standard
G0484 Document complaint and resolution Element
G0514 RN performs assessment Element
G0520 5 calendar days after start of care Element
G0536 A review of all current medications Element
G0584 Verbal orders Element
G0608 Coordinate care delivery Element
G0710 Provide services in the plan of care Element
G0716 Preparing clinical notes Element
G0948 Responsible for all day-to-day operations Element
▼ 058410 Aaa Home Health Services, Inc 3806 W Magnolia Blvd Suite A Burbank CA 9 (San Francisco) 12/09/2019 EIP311 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0750 Home health aide services Condition
G0768 Competency evaluation Standard
G0754 A qualified HH aide successfully completed: Element
▼ 058412 Flower Home Health, Inc. 9057 Arrow Route Suite 180 Rancho Cucamonga CA 9 (San Francisco) 02/14/2020 LHSZ11 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
E0032 Primary/Alternate Means for Communication Standard
G0374 Accuracy of encoded OASIS data Standard
G1010 Contents of clinical record Standard
G0580 Only as ordered by a physician Element
G0616 Patient medication schedule/instructions Element
▼ 058414 Sunshine Home Health Services, Inc 4201 Long Beach Blvd Suite 412b Long Beach CA 9 (San Francisco) 06/06/2019 LB4X11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0372 Encoding and transmitting OASIS Standard
G0536 A review of all current medications Element
G0580 Only as ordered by a physician Element
G0710 Provide services in the plan of care Element
G0718 Communication with physicians Element
G1022 Discharge and transfer summaries Element
▼ 058415 Prohealth Home Care, Inc 2700 Zanker Road, Suite 180 San Jose CA 9 (San Francisco) 03/02/2023 5F103-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0682 Infection Prevention Standard
G0514 RN performs assessment Element
G0536 A review of all current medications Element
G0708 Development and evaluation of plan of care Element
G0710 Provide services in the plan of care Element
G0716 Preparing clinical notes Element
G0808 Onsite supervisory visit every 14 days Element
▼ 058415 Prohealth Home Care, Inc 2700 Zanker Road, Suite 180 San Jose CA 9 (San Francisco) 04/25/2018 MSFC11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0536 A review of all current medications Element
▼ 058417 Home Health Care Solutions, Inc. 8560 Vineyard Ave. Suite 504a Rancho Cucamonga CA 9 (San Francisco) 02/20/2026 1E3F75-H1 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
E0023 Policies/Procedures for Medical Documentation Standard
G0658 Performance improvement projects Standard
G0444 State toll free HH telephone hotline Element
G1012 Required items in clinical record Element