S&C QCOR HHA 2567s
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HHAs 2567s
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Provider Characteristics

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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
▼ 467226 Home Caregivers Partnership, Llc 302 West 5400 South Murray UT 8 (Denver) 01/05/2022 381F0-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0518 Completion of the comprehensive assessment Standard
G0564 Discharge or Transfer Summary Content Standard
G0572 Plan of care Standard
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0580 Only as ordered by a physician Element
G0606 Integrate all services Element
▼ 467226 Home Caregivers Partnership, Llc 302 West 5400 South Murray UT 8 (Denver) 02/14/2019 VZ1311 Recertification
Deficiency Tag Deficiency Description Tag Type
E0017 HHA Comprehensive Assessment in Disaster Standard
G0574 Plan of care must include the following Element
G0576 All orders recorded in plan of care Element
G0808 Onsite supervisory visit every 14 days Element
▼ 467230 Ivy Lane Pediatrics, Llc 5974 Fashion Point Drive, Suite 230 South Ogden UT 8 (Denver) 01/16/2018 5W3911 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0122 ORGANIZATION, SERVICES & ADMINISTRATION Condition
G0156 ACCEPTANCE OF PATIENTS, POC, MED SUPER Condition
G0235 CLINICAL RECORDS Condition
G0128 GOVERNING BODY Standard
G0134 ADMINISTRATOR Standard
G0144 COORDINATION OF PATIENT SERVICES Standard
G0157 ACCEPTANCE OF PATIENTS, POC, MED SUPER Standard
G0158 ACCEPTANCE OF PATIENTS, POC, MED SUPER Standard
G0159 PLAN OF CARE Standard
G0174 DUTIES OF THE REGISTERED NURSE Standard
G0176 DUTIES OF THE REGISTERED NURSE Standard
G0214 COMPETENCY EVALUATION & IN-SERVICE TRAI Standard
G0215 COMPETENCY EVALUATION & IN-SERVICE TRAI Standard
G0218 COMPETENCY EVALUATION & IN-SERVICE TRAI Standard
G0229 SUPERVISION Standard
G0230 SUPERVISION Standard
G0236 CLINICAL RECORDS Standard
G0337 DRUG REGIMEN REVIEW Standard
▼ 467232 Legacy Healthcare, Inc. 880 W Heritage Park Boulevard, Suite 200 Layton UT 8 (Denver) 07/05/2018 VECI11 Complaint, 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
G0940 Organization and administration of services Condition
G1008 Clinical records Condition
G0774 12 hours inservice every 12 months Standard
G0942 Governing body Standard
G0484 Document complaint and resolution Element
G0574 Plan of care must include the following Element
G0580 Only as ordered by a physician Element
G0590 Promptly alert relevant physician of changes Element
G0602 Communication with all physicians Element
G0608 Coordinate care delivery Element
G0952 Ensure that HHA employs qualified personnel Element
G0972 Report all branch locations to SA Element
G1012 Required items in clinical record Element
G1022 Discharge and transfer summaries Element
▼ 467232 Legacy Healthcare, Inc. 880 W Heritage Park Boulevard, Suite 200 Layton UT 8 (Denver) 01/04/2018 OGV011 Complaint
Deficiency Tag Deficiency Description Tag Type
G0158 ACCEPTANCE OF PATIENTS, POC, MED SUPER Standard
G0164 PERIODIC REVIEW OF PLAN OF CARE Standard
G0229 SUPERVISION Standard
▼ 467233 Elite Home Health Utah Llc 3333 North Digital Drive Lehi UT 8 (Denver) 10/10/2018 0S8O11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
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
G0578 Conformance with physician orders Standard
G0768 Competency evaluation Standard
G0774 12 hours inservice every 12 months Standard
G0860 Licensing Standard
G0942 Governing body Standard
G0976 Services under arrangement Standard
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
G0596 Revisions communicated to patient and MDs Element
G0602 Communication with all physicians Element
G0608 Coordinate care delivery Element
G0716 Preparing clinical notes Element
G0812 Direct observation every 12 months Element
▼ 467234 Primrose Home Care, Inc. 286 North Gateway Drive, Suite 101 Providence UT 8 (Denver) 04/17/2023 5F8DA-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
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
E0039 EP Testing Requirements Standard
G0526 Content of the comprehensive assessment Standard
G0684 Infection control Standard
G0702 Services by skilled professionals Standard
G0958 Clinical manager Standard
G0520 5 calendar days after start of care Element
G0574 Plan of care must include the following Element
G0580 Only as ordered by a physician Element
G0608 Coordinate care delivery Element
G0952 Ensure that HHA employs qualified personnel Element
▼ 467234 Primrose Home Care, Inc. 286 North Gateway Drive, Suite 101 Providence UT 8 (Denver) 03/04/2020 6UY511 Complaint, Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
E0017 HHA Comprehensive Assessment in Disaster Standard
G0686 Infection control education Standard
G0942 Governing body Standard
G0412 Written notice of patient's rights Element
G0436 Receive all services in plan of care Element
G0574 Plan of care must include the following Element
G0582 Influenza and pneumococcal vaccines Element
G0952 Ensure that HHA employs qualified personnel Element
▼ 467236 Dixie Home Rehab, Llc 352 East Riverside Drive St. George UT 8 (Denver) 02/06/2019 CS4I11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0570 Care planning, coordination, quality of care Condition
G0576 All orders recorded in plan of care Element
G0602 Communication with all physicians Element
▼ 467237 Good Shepherd Hospice And Home Care Of Eastern Utah Inc. 1680 West Highway 40, Suite 104 Vernal UT 8 (Denver) 12/05/2025 1D7AF4-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
G0686 Infection control education Standard
G0774 12 hours inservice every 12 months Standard
G0722 Participate in HHA-sponsored in-service Element