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
▼ 059018 Wellness Home Health Care Inc 2550 Honolulu Ave., Suite 206 Montrose CA 9 (San Francisco) 03/16/2023 5F46A-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0612 Written instructions to patient include: Standard
G0682 Infection Prevention Standard
G0616 Patient medication schedule/instructions Element
G0710 Provide services in the plan of care Element
▼ 059018 Wellness Home Health Care Inc 2550 Honolulu Ave., Suite 206 Montrose CA 9 (San Francisco) 12/30/2019 COC511 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0532 Continuing need for home care Element
▼ 059020 Brio Home Health Services,Inc. 12590 Central Ave. Chino CA 9 (San Francisco) 06/19/2026 235AD5-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0612 Written instructions to patient include: Standard
G0684 Infection control Standard
G0536 A review of all current medications Element
▼ 059020 Brio Home Health Services,Inc. 12590 Central Ave. Chino CA 9 (San Francisco) 05/25/2023 5FD5E-H1 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
G0642 Program scope Standard
G0644 Program data Standard
G0658 Performance improvement projects Standard
G0660 Executive responsibilities for QAPI Standard
G0514 RN performs assessment Element
G0580 Only as ordered by a physician Element
G1012 Required items in clinical record Element
▼ 059020 Brio Home Health Services,Inc. 12590 Central Ave. Chino CA 9 (San Francisco) 09/06/2018 KHXQ11 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
G0536 A review of all current medications Element
G0608 Coordinate care delivery Element
G1012 Required items in clinical record Element
▼ 059021 New Life Venture Corp 226 West E Street Ontario CA 9 (San Francisco) 01/23/2026 1E1290-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
▼ 059021 New Life Venture Corp 226 West E Street Ontario CA 9 (San Francisco) 01/25/2023 5EC3B-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
G0572 Plan of care Standard
G0514 RN performs assessment Element
G0726 Nursing services supervised by RN Element
▼ 059022 Dependable Home Health, Inc. 16922 Airport Boulevard, Building 1, Suite 17 Mojave CA 9 (San Francisco) 07/20/2018 RVGM11 Recertification, Sample Validation
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
G0610 Patients receive education and training Element
G0706 Interdisciplinary assessment of the patient Element
G0714 Patient and caregiver education Element
G0716 Preparing clinical notes Element
▼ 059023 Arken Healthcare Services Inc 1700 Iowa Ave Riverside CA 9 (San Francisco) 09/10/2024 64207-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0580 Only as ordered by a physician Element
▼ 059025 Sanrose Home Health Services, Inc 41865 Boardwalk Ste 206 Palm Desert CA 9 (San Francisco) 08/06/2019 IMI711 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0574 Plan of care must include the following Element