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
▼ 447579 Maim Healthcare Services, Inc 10024 Investment Drive Ste 130 Knoxville TN 4 (Atlanta) 11/13/2019 Z5QO11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0488 Immediate reporting of abuse by all staff Element
▼ 447579 Maim Healthcare Services, Inc 10024 Investment Drive Ste 130 Knoxville TN 4 (Atlanta) 09/24/2019 E8LU11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0430 Be free from abuse Element
▼ 447579 Maim Healthcare Services, Inc 10024 Investment Drive Ste 130 Knoxville TN 4 (Atlanta) 06/25/2019 3V3H11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0430 Be free from abuse Element
▼ 447581 Adoration Home Health Llc 1210 Briarville Rd., Bldg. D, Ste. B Madison TN 4 (Atlanta) 05/28/2026 233D36-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G1022 Discharge and transfer summaries Element
▼ 447581 Adoration Home Health Llc 1210 Briarville Rd., Bldg. D, Ste. B Madison TN 4 (Atlanta) 09/20/2018 YK4311 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0574 Plan of care must include the following Element
G0588 Reviewed, revised by physician every 60 days Element
▼ 447582 Maxim Healthcare Services, Inc 1255 Lynnfield Rd, Suite 295 Memphis TN 4 (Atlanta) 11/18/2021 37F1F-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0570 Care planning, coordination, quality of care Condition
G0572 Plan of care Standard
▼ 447584 Extended Health Care, Llc 7424 Highway 64, Suite 118, Ste A Bartlett TN 4 (Atlanta) 06/23/2023 602E3-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
G0686 Infection control education Standard
G0536 A review of all current medications Element
G1022 Discharge and transfer summaries Element
▼ 447586 Maxim Healthcare Services 208 Sunset Drive Suite 503 Johnson City TN 4 (Atlanta) 08/27/2019 3XSH11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0580 Only as ordered by a physician Element
G0710 Provide services in the plan of care Element
▼ 453103 Angels Of Hands Home Health Agency Corp 1801 N Hampton Rd Ste 382 Desoto TX 6 (Dallas) 09/20/2018 M0BV11 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
G0642 Program scope Standard
G0434 Participate in care Element
G0574 Plan of care must include the following Element
▼ 453103 Angels Of Hands Home Health Agency Corp 1801 N Hampton Rd Ste 382 Desoto TX 6 (Dallas) 09/20/2018 XVKQ12 Complaint
Deficiency Tag Deficiency Description Tag Type
G0143 COORDINATION OF PATIENT SERVICES Standard