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
▼ 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
▼ 387150 Guardian Home Care, Inc. 2502 Cove Avenue, Suite A La Grande OR 10 (Seattle) 06/13/2019 QJIH11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0372 Encoding and transmitting OASIS Standard
▼ 387151 Adams & Gray, Inc. 4560 Se International Way, Suite 100 Milwaukie OR 10 (Seattle) 03/07/2025 65742-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0039 EP Testing Requirements Standard
▼ 387155 Avalon Home Health, Llc 132 E. Broadway, Suite 215 Eugene OR 10 (Seattle) 04/03/2019 43Z511 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0001 Establishment of the Emergency Program (EP) Condition
G0406 Patient rights Condition
G0940 Organization and administration of services Condition
E0004 Develop EP Plan, Review and Update Annually Standard
E0006 Plan Based on All Hazards Risk Assessment Standard
E0037 EP Training Program Standard
E0039 EP Testing Requirements Standard
G0372 Encoding and transmitting OASIS Standard
G0682 Infection Prevention Standard
G0412 Written notice of patient's rights Element
G0416 OASIS privacy notice Element
G0432 Make complaints to the HHA Element
G0444 State toll free HH telephone hotline Element
G0514 RN performs assessment Element
G0536 A review of all current medications Element
▼ 387161 Oregon Continental Home Health Care, Inc 341 Se 3rd Avenue Hillsboro OR 10 (Seattle) 02/08/2023 5F095-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0940 Organization and administration of services Condition
E0039 EP Testing Requirements Standard
G0590 Promptly alert relevant physician of changes Element
G0710 Provide services in the plan of care Element