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
▼ 467237 Good Shepherd Hospice And Home Care Of Eastern Utah Inc. 1680 West Highway 40, Suite 104 Vernal UT 8 (Denver) 03/10/2022 3869F-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0570 Care planning, coordination, quality of care Condition
G0640 Quality assessment/performance improvement Condition
G0940 Organization and administration of services Condition
G0942 Governing body Standard
G0576 All orders recorded in plan of care Element
▼ 467237 Good Shepherd Hospice And Home Care Of Eastern Utah Inc. 1680 West Highway 40, Suite 104 Vernal UT 8 (Denver) 04/24/2019 CZ5F11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0017 HHA Comprehensive Assessment in Disaster Standard
G0682 Infection Prevention Standard
G0702 Services by skilled professionals 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
G0602 Communication with all physicians Element
▼ 467238 Chase Healthcare Llc 406 West South Jordan Parkway South Jordan UT 8 (Denver) 05/12/2025 6606C-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0570 Care planning, coordination, quality of care Condition
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
G0580 Only as ordered by a physician Element
G0602 Communication with all physicians Element
▼ 467238 Chase Healthcare Llc 406 West South Jordan Parkway South Jordan UT 8 (Denver) 01/12/2022 3829A-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0037 EP Training Program Standard
G0686 Infection control education Standard
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
▼ 467239 Dignity Home Health Of Utah 174 South 1100 East American Fork UT 8 (Denver) 03/05/2025 658C3-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0414 HHA administrator contact information Element
G0446 Contact info Federal/State-funded entities Element
▼ 467239 Dignity Home Health Of Utah 174 South 1100 East American Fork UT 8 (Denver) 01/12/2022 38296-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0510 Comprehensive Assessment of Patients Condition
G0570 Care planning, coordination, quality of care Condition
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
G0576 All orders recorded in plan of care Element
G0580 Only as ordered by a physician Element
G0590 Promptly alert relevant physician of changes Element
▼ 467242 Inspiration Home Health, Llc 1649 East 1400 South, Suite 140 Clearfield UT 8 (Denver) 04/11/2024 62C61-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
▼ 467245 Refined Home Health And Personal Care Llc 623 E Fort Union Boulvard, Suite 105 Midvale UT 8 (Denver) 03/11/2026 1F37DD-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0039 EP Testing Requirements Standard
G0488 Immediate reporting of abuse by all staff Element
▼ 467245 Refined Home Health And Personal Care Llc 623 E Fort Union Boulvard, Suite 105 Midvale UT 8 (Denver) 11/03/2022 5E329-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0700 Skilled professional services Condition
▼ 467248 Horizon Home Health 11 East 200 North Orem UT 8 (Denver) 04/15/2026 22F220-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
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
E0017 HHA Comprehensive Assessment in Disaster Standard
E0037 EP Training Program Standard
G0642 Program scope Standard
G0686 Infection control education Standard
G0536 A review of all current medications Element
G0546 Last 5 days of every 60 days unless: Element
G0548 Within 48 hours of the patient's return Element
G0574 Plan of care must include the following Element
G0580 Only as ordered by a physician Element
G0588 Reviewed, revised by physician every 60 days Element
G0952 Ensure that HHA employs qualified personnel Element
G1022 Discharge and transfer summaries Element