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
▼ 467121 Avamere Home Health Care, Llc D/B/A Signature Homecare At Home - Slchh 5965 South 900 East, Suite 200 Murray UT 8 (Denver) 10/01/2019 VZHM11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0546 Last 5 days of every 60 days unless: Element
G0808 Onsite supervisory visit every 14 days Element
G0814 Non-skilled direct observation every 60 days Element
▼ 467200 Ezra Healthcare, Llc 3125 W Executive Parkway Lehi UT 8 (Denver) 03/13/2019 29V011 Recertification
Deficiency Tag Deficiency Description Tag Type
G0510 Comprehensive Assessment of Patients Condition
G0570 Care planning, coordination, quality of care Condition
G0640 Quality assessment/performance improvement Condition
G0700 Skilled professional services Condition
G0940 Organization and administration of services Condition
E0017 HHA Comprehensive Assessment in Disaster Standard
E0039 EP Testing Requirements Standard
G0572 Plan of care Standard
G0578 Conformance with physician orders Standard
G0586 Review and revision of the plan of care Standard
G0600 Coordination of Care Standard
G0684 Infection control Standard
G0704 Responsibilities of skilled professionals Standard
G0774 12 hours inservice every 12 months Standard
G0958 Clinical manager Standard
G1052 Administrator Standard
G0520 5 calendar days after start of care Element
G0534 Patient's needs Element
G0574 Plan of care must include the following Element
G0580 Only as ordered by a physician Element
G0808 Onsite supervisory visit every 14 days Element
G0812 Direct observation every 12 months Element
G0952 Ensure that HHA employs qualified personnel Element
▼ 467207 Belle Vie Home Health Llc 428 East Winchester Street Murray UT 8 (Denver) 01/12/2026 1E121F-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0017 HHA Comprehensive Assessment in Disaster Standard
▼ 467207 Belle Vie Home Health Llc 428 East Winchester Street Murray UT 8 (Denver) 05/11/2022 4EA58-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0848 Compliance with Federal, State, Local Law Condition
E0006 Plan Based on All Hazards Risk Assessment Standard
E0017 HHA Comprehensive Assessment in Disaster Standard
G0860 Licensing Standard
▼ 467210 Cozy Healthcare, Inc. 6985 S Union Park Center, Suite 285 Midvale UT 8 (Denver) 06/03/2019 3Z2M11 Complaint, Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0406 Patient rights Condition
G0570 Care planning, coordination, quality of care Condition
G0700 Skilled professional services Condition
G1008 Clinical records Condition
G0600 Coordination of Care Standard
G0682 Infection Prevention Standard
G1024 Authentication Standard
G0454 HHA can no longer meet the patient's needs Element
G0574 Plan of care must include the following Element
G0576 All orders recorded in plan of care Element
G0580 Only as ordered by a physician Element
G0602 Communication with all physicians Element
G0710 Provide services in the plan of care Element
G0800 Services provided by HH aide Element
▼ 467210 Cozy Healthcare, Inc. 6985 S Union Park Center, Suite 285 Midvale UT 8 (Denver) 03/15/2018 QHWX11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0001 Establishment of the Emergency Program (EP) 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
G1008 Clinical records Condition
G0612 Written instructions to patient include: Standard
G0774 12 hours inservice every 12 months Standard
G0942 Governing body Standard
G0574 Plan of care must include the following Element
G0580 Only as ordered by a physician Element
G0592 Revised plan of care Element
G0606 Integrate all services Element
G0722 Participate in HHA-sponsored in-service Element
G0808 Onsite supervisory visit every 14 days Element
G0950 Ensure clinical manager is available Element
G0952 Ensure that HHA employs qualified personnel Element
G1022 Discharge and transfer summaries Element
▼ 467212 Maxim Healthcare Services, Inc. 9815 South Monroe St., Suite 400 Sandy UT 8 (Denver) 03/12/2020 8UZ411 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0406 Patient rights Condition
G0560 Discharge Planning Condition
G0570 Care planning, coordination, quality of care Condition
G0640 Quality assessment/performance improvement Condition
G0940 Organization and administration of services Condition
G0562 Discharge Planning Standard
G0564 Discharge or Transfer Summary Content Standard
G0942 Governing body Standard
G0982 Skilled services furnished Standard
G0436 Receive all services in plan of care Element
G0608 Coordinate care delivery Element
G0954 Ensures qualified pre-designated person Element
▼ 467213 Valeo Home Healthcare Services, Llc 5250 South Commerce Drive Murray UT 8 (Denver) 01/02/2025 6501D-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
▼ 467214 Onecare Home Health Utah, Llc 1751 West Alexander Street West Valley City UT 8 (Denver) 03/13/2024 627F6-H1 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
G0940 Organization and administration of services Condition
G0572 Plan of care Standard
G0686 Infection control education Standard
G0768 Competency evaluation Standard
G0852 Information to the state survey agency Standard
G0942 Governing body Standard
G0722 Participate in HHA-sponsored in-service Element
▼ 467225 Utah Home Health And Hospice, Llc 358 West Center Street Orem UT 8 (Denver) 12/28/2023 61D5D-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
G0972 Report all branch locations to SA Element