S&C QCOR Hospice 2567s
d QCOR:  Quality, Certification and Oversight Reports.
Hospice 2567s
Selection Criteria

Time Interval

Please select the calendar year or years for which you would like data.

Note: Hospice 2567s data are available from October 2021 through March 2026.

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 Hospice 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

Use these filters if you want to search by a specific CMS Certification Number (CCN).

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. Surveys can also be filtered by surveyor type - State Agency or Accrediting Organization - and by whether immediate jeopardy was cited.

CMS Certification Number Facility Name Address City State CMS Region Survey Date Surveyed By Survey Event ID Survey Type Statement of Deficiencies Report
241559 Lakewood Health System Hospice 401 East Prairie Avenue Staples MN 5 (Chicago) 06/30/2022 State Agency UG3U11 Complaint, Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments Memo
L0000 Initial Comments Memo
L0533 Update Of Comprehensive Assessment Standard
L0691 Dispensing Of Drugs And Biologicals Standard
241563 Lifecare Hospice 715 Delmore Drive Roseau MN 5 (Chicago) 09/27/2023 State Agency 60BCC-H1 Focused Infection Control, Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments Memo
L0000 Initial Comments Memo
L0625 Hospice Aide Assignments And Duties Standard
L0629 Supervision Of Hospice Aides Standard
241564 Essentia Health Hospice West 900 Hilligoss Blvd Southeast Fosston MN 5 (Chicago) 08/23/2023 State Agency 605FC-H1 Complaint, Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments Memo
L0000 Initial Comments Memo
L0545 Content Of Plan Of Care Standard
L0667 Initial Certification Of Terminal Illness Standard
L0684 Discharge Or Transfer Of Care Standard
241566 Northfield Hospice 1604 Riverview Drive Northfield MN 5 (Chicago) 10/07/2021 State Agency ILAK11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments Memo
L0000 Initial Comments Memo
L0508 Exercise Of Rights/Respect For Proprty/Person Standard
L0629 Supervision Of Hospice Aides Standard
241573 Our Lady Of Peace 2076 St Anthony Avenue Saint Paul MN 5 (Chicago) 10/18/2022 State Agency 5DF31-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
L0000 Initial Comments Memo
L0509 Exercise Of Rights/Respect For Proprty/Person Standard
L0545 Content Of Plan Of Care Standard
241573 Our Lady Of Peace 2076 St Anthony Avenue Saint Paul MN 5 (Chicago) 10/25/2023 State Agency 60FA5-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments Memo
L0000 Initial Comments Memo
L0579 Prevention Standard
L0676 Content Standard
241573 Our Lady Of Peace 2076 St Anthony Avenue Saint Paul MN 5 (Chicago) 10/25/2023 State Agency 60FA5-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 Initial Comments Memo
K0353 Sprinkler System - Maintenance And Testing Standard
K0741 Smoking Regulations Standard
K0761 Maintenance, Inspection & Testing - Doors Standard
K0920 Electrical Equipment ? Power Cords And Extension Cords Standard
241574 Range Regional Health Services 750 East 34th Street Hibbing MN 5 (Chicago) 02/24/2023 TJC 444638085 Initial
Deficiency Tag Deficiency Description Tag Type
L0531 Content Of Comprehensive Assessment Standard
L0545 Content Of Plan Of Care Standard
L0549 Content Of Plan Of Care Standard
L0579 Prevention Standard
L0625 Hospice Aide Assignments And Duties Standard
L0651 Governing Body And Administrator Standard
L0674 Content Standard
L0695 Label Dispose Storage Drugs Standard
241574 Range Regional Health Services 750 East 34th Street Hibbing MN 5 (Chicago) 05/31/2024 TJC 451245705 Reaccreditation
Deficiency Tag Deficiency Description Tag Type
L0536 Idg, Care Planning, Coordination Of Services Condition
L0545 Content Of Plan Of Care Standard
L0579 Prevention Standard
L0629 Supervision Of Hospice Aides Standard
L0651 Governing Body And Administrator Condition
241575 In Home Health, Llc 1257 2nd Street N Sauk Rapids MN 5 (Chicago) 02/11/2022 ACHC 41473 Reaccreditation
Deficiency Tag Deficiency Description Tag Type
L0547 Content Of Plan Of Care Standard
L0549 Content Of Plan Of Care Standard
L0555 Coordination Of Services Standard
L0679 Authentication Standard