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
▼ 387147 First Call Home Health Agency, Llc 2608 Cascadia Industrial Street Se Salem OR 10 (Seattle) 12/28/2022 5E9AE-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0682 Infection Prevention Standard
▼ 387147 First Call Home Health Agency, Llc 2608 Cascadia Industrial Street Se Salem OR 10 (Seattle) 05/03/2021 4UGS11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0426 Rights of the patient Standard
▼ 387147 First Call Home Health Agency, Llc 2608 Cascadia Industrial Street Se Salem OR 10 (Seattle) 01/28/2020 XHJR11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
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
G0940 Organization and administration of services Condition
G1050 Personnel qualifications Condition
G0572 Plan of care Standard
G0578 Conformance with physician orders Standard
G0600 Coordination of Care Standard
G0702 Services by skilled professionals Standard
G0724 Supervise skilled professional assistants Standard
G0942 Governing body Standard
G0958 Clinical manager Standard
G1028 Protection of records Standard
G1052 Administrator Standard
G1056 Clinical Manager Standard
G0514 RN performs assessment Element
G0532 Continuing need for home care Element
G0574 Plan of care must include the following Element
G0580 Only as ordered by a physician Element
G0590 Promptly alert relevant physician of changes Element
G0592 Revised plan of care Element
G0602 Communication with all physicians Element
G0706 Interdisciplinary assessment of the patient Element
G0716 Preparing clinical notes Element
G0718 Communication with physicians Element
G0726 Nursing services supervised by RN Element
G0808 Onsite supervisory visit every 14 days Element
G0856 Officer, a director, agent, managing employee Element
G0858 Responsible for the management of the HHA Element
G0948 Responsible for all day-to-day operations Element
G0950 Ensure clinical manager is available Element
G0962 Coordinate patient care Element
G1012 Required items in clinical record Element
▼ 387147 First Call Home Health Agency, Llc 2608 Cascadia Industrial Street Se Salem OR 10 (Seattle) 01/16/2019 0SPW11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0372 Encoding and transmitting OASIS Standard
G0514 RN performs assessment Element
G0808 Onsite supervisory visit every 14 days Element
G1014 Interventions and patient response Element
▼ 387148 Mount Hood Healthcare Llc 7632 Sw Durham Road, Suite 100 Tigard OR 10 (Seattle) 05/08/2023 5FBEC-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0536 A review of all current medications Element
G0590 Promptly alert relevant physician of changes Element
▼ 387148 Mount Hood Healthcare Llc 7632 Sw Durham Road, Suite 100 Tigard OR 10 (Seattle) 01/04/2023 5EA30-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0514 RN performs assessment Element
▼ 387148 Mount Hood Healthcare Llc 7632 Sw Durham Road, Suite 100 Tigard OR 10 (Seattle) 09/12/2019 F8Z411 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
E0039 EP Testing Requirements Standard
G0372 Encoding and transmitting OASIS Standard
G0484 Document complaint and resolution Element
G0514 RN performs assessment Element
G0536 A review of all current medications Element
G0808 Onsite supervisory visit every 14 days Element
G1014 Interventions and patient response Element
▼ 387148 Mount Hood Healthcare Llc 7632 Sw Durham Road, Suite 100 Tigard OR 10 (Seattle) 07/18/2018 JMFP11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0808 Onsite supervisory visit every 14 days Element
▼ 387149 The Evangelical Lutheran Good Samaritan Society 935 Willagillespie Road, Suite A Eugene OR 10 (Seattle) 05/05/2022 38A07-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0030 Names and Contact Information Standard
G0718 Communication with physicians Element
▼ 387150 Guardian Home Care, Inc. 2502 Cove Avenue, Suite A La Grande OR 10 (Seattle) 08/11/2022 4F3B7-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0616 Patient medication schedule/instructions Element