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
▼ 058479 St. George Health Care, Inc. 1850 Gateway Blvd., Ste. 225 Concord CA 9 (San Francisco) 05/01/2025 65FD8-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0570 Care planning, coordination, quality of care Condition
G1008 Clinical records Condition
G0774 12 hours inservice every 12 months Standard
G0436 Receive all services in plan of care Element
G0580 Only as ordered by a physician Element
G0590 Promptly alert relevant physician of changes Element
G0606 Integrate all services Element
G0984 In accordance with current clinical practice Element
G1012 Required items in clinical record Element
▼ 058479 St. George Health Care, Inc. 1850 Gateway Blvd., Ste. 225 Concord CA 9 (San Francisco) 02/17/2022 3850B-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0608 Coordinate care delivery Element
G0614 Visit schedule Element
▼ 059000 Miracle Home Health Care, Inc 5670 Wilshire Blvd, Suite 1600 Los Angeles CA 9 (San Francisco) 07/19/2024 63A2E-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0514 RN performs assessment Element
G0520 5 calendar days after start of care Element
G0528 Health, psychosocial, functional, cognition Element
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0576 All orders recorded in plan of care Element
G0590 Promptly alert relevant physician of changes Element
G0592 Revised plan of care Element
G0602 Communication with all physicians Element
G1012 Required items in clinical record Element
▼ 059000 Miracle Home Health Care, Inc 5670 Wilshire Blvd, Suite 1600 Los Angeles CA 9 (San Francisco) 04/02/2023 5F661-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
G0940 Organization and administration of services Condition
G0514 RN performs assessment Element
G0536 A review of all current medications Element
G0580 Only as ordered by a physician Element
G0590 Promptly alert relevant physician of changes Element
G0608 Coordinate care delivery Element
G0610 Patients receive education and training Element
G0614 Visit schedule Element
G0710 Provide services in the plan of care Element
G0718 Communication with physicians Element
G0966 Assure patient needs are continually assessed Element
▼ 059000 Miracle Home Health Care, Inc 5670 Wilshire Blvd, Suite 1600 Los Angeles CA 9 (San Francisco) 11/09/2021 37E99-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0410 Information to patient Element
▼ 059014 Genus Home Care Of San Bernardino 515 N Mountain View San Bernardino CA 9 (San Francisco) 06/08/2023 5FEBA-H1 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
E0019 Homebound HHA/Hospice Inform EP Officials Standard
G0644 Program data Standard
G0646 Program activities Standard
G0654 Track adverse patient events Standard
G0658 Performance improvement projects Standard
G0660 Executive responsibilities for QAPI Standard
G0682 Infection Prevention Standard
G0576 All orders recorded in plan of care Element
G0590 Promptly alert relevant physician of changes Element
G1012 Required items in clinical record Element
▼ 059015 Triune Home Health Provider, Inc 4959 Palo Verde St. Suite 206c-6 Montclair CA 9 (San Francisco) 08/23/2024 63EF0-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
G0536 A review of all current medications Element
G0580 Only as ordered by a physician Element
G0950 Ensure clinical manager is available Element
G1022 Discharge and transfer summaries Element
▼ 059015 Triune Home Health Provider, Inc 4959 Palo Verde St. Suite 206c-6 Montclair CA 9 (San Francisco) 01/13/2022 3825E-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0550 At discharge Element
G0584 Verbal orders Element
▼ 059015 Triune Home Health Provider, Inc 4959 Palo Verde St. Suite 206c-6 Montclair CA 9 (San Francisco) 01/13/2022 3825F-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0710 Provide services in the plan of care Element
▼ 059015 Triune Home Health Provider, Inc 4959 Palo Verde St. Suite 206c-6 Montclair CA 9 (San Francisco) 03/16/2021 5R3Q11 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
G0510 Comprehensive Assessment of Patients Condition
G0570 Care planning, coordination, quality of care Condition
G0640 Quality assessment/performance improvement Condition
G0680 Infection prevention and control Condition
G0940 Organization and administration of services Condition
E0004 Develop EP Plan, Review and Update Annually Standard
E0017 HHA Comprehensive Assessment in Disaster Standard
E0037 EP Training Program Standard
E0039 EP Testing Requirements Standard
G0518 Completion of the comprehensive assessment Standard
G0572 Plan of care Standard
G0642 Program scope Standard
G0644 Program data Standard
G0658 Performance improvement projects Standard
G0660 Executive responsibilities for QAPI Standard
G0684 Infection control Standard
G0942 Governing body Standard
G0958 Clinical manager Standard
G0520 5 calendar days after start of care Element
G0536 A review of all current medications Element
G0546 Last 5 days of every 60 days unless: Element
G0952 Ensure that HHA employs qualified personnel Element