S&C QCOR Hospice 2567s
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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
▼ 241577 Clearwater Hospice 212 Main Avenue North Bagley MN 5 (Chicago) 04/03/2023 State Agency 5F4C9-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments Memo
L0000 Initial Comments Memo
L0549 Content Of Plan Of Care Standard
▼ 241578 Triniti Hospice 403 Main Street Nw Elk River MN 5 (Chicago) 06/14/2023 State Agency 5FC41-H1 Complaint, Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments Memo
L0000 Initial Comments Memo
L0530 Content Of Comprehensive Assessment Standard
▼ 241579 Odyssey Healthcare Holding Company 7389 Airport View Drive Sw Suite 300 Rochester MN 5 (Chicago) 02/03/2022 ACHC 41425 Reaccreditation
Deficiency Tag Deficiency Description Tag Type
L0531 Content Of Comprehensive Assessment Standard
L0549 Content Of Plan Of Care Standard
L0555 Coordination Of Services Standard
L0625 Hospice Aide Assignments And Duties Standard
L0626 Hospice Aide Assignments And Duties Standard
L0667 Initial Certification Of Terminal Illness Standard
L0668 Recertification Of The Terminal Illness Standard
L0679 Authentication Standard
L0796 Criminal Background Checks Standard
▼ 241579 Odyssey Healthcare Holding Company 7389 Airport View Drive Sw Suite 300 Rochester MN 5 (Chicago) 01/15/2025 ACHC 1254633 Reaccreditation
Deficiency Tag Deficiency Description Tag Type
E0039 Ep Testing Requirements Standard
L0515 Rights Of The Patient Standard
L0524 Content Of Comprehensive Assessment Standard
L0530 Content Of Comprehensive Assessment Standard
L0536 Idg, Care Planning, Coordination Of Services Condition
L0540 Approach To Service Delivery Standard
L0545 Content Of Plan Of Care Standard
L0549 Content Of Plan Of Care Standard
L0550 Content Of Plan Of Care Standard
L0552 Review Of The Plan Of Care Standard
L0553 Review Of The Plan Of Care Standard
L0569 Program Activities Standard
L0596 Counseling Services Standard
L0615 Competency Evaluation Standard
L0625 Hospice Aide Assignments And Duties Standard
L0626 Hospice Aide Assignments And Duties Standard
L0629 Supervision Of Hospice Aides Standard
L0655 Professional Management Responsibility Standard
L0673 Content Standard
L0774 Hospice Plan Of Care Standard
L0781 Coordination Of Services Standard
L0784 Personnel Qualification Standard
L0795 Criminal Background Checks Standard
L0796 Criminal Background Checks Standard
▼ 241579 Odyssey Healthcare Holding Company 7389 Airport View Drive Sw Suite 300 Rochester MN 5 (Chicago) 02/26/2025 ACHC 1254866 Follow-Up
Deficiency Tag Deficiency Description Tag Type
L0530 Content Of Comprehensive Assessment Standard
L0547 Content Of Plan Of Care Standard
L0549 Content Of Plan Of Care Standard
L0679 Authentication Standard
▼ 241580 Avera@Home Pipestone 916 4th Avenue Southwest Pipestone MN 5 (Chicago) 06/08/2023 State Agency 5FCC1-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments Memo
L0000 Initial Comments Memo
L0530 Content Of Comprehensive Assessment Standard
L0547 Content Of Plan Of Care Standard
L0554 Coordination Of Services Standard
L0598 Counseling Services Standard
L0677 Content Standard
L0688 Managing Drugs And Biologicals Standard
▼ 241581 Good Samaritan Society Hospice 24090 Smiley Road, Suite 200 Nisswa MN 5 (Chicago) 09/22/2022 State Agency 0U6C11 Complaint, Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments Memo
E0039 Ep Testing Requirements Standard
L0000 Initial Comments Memo
L0555 Coordination Of Services Standard
L0556 Coordination Of Services Standard
L0684 Discharge Or Transfer Of Care Standard
▼ 241581 Good Samaritan Society Hospice 24090 Smiley Road, Suite 200 Nisswa MN 5 (Chicago) 01/09/2025 State Agency 64AF8-H1 Complaint, Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments Memo
L0000 Initial Comments Memo
L0549 Content Of Plan Of Care Standard
L0555 Coordination Of Services Standard
L0580 Control Standard
L0629 Supervision Of Hospice Aides Standard
L0647 Level Of Activity Standard
L0677 Content Standard
▼ 241582 Minnesota Hospice Llc 17645 Juniper Path Suite 155 Lakeville MN 5 (Chicago) 10/28/2021 State Agency 2JDO11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments Memo
E0024 Policies/Procedures-Volunteers And Staffing Standard
L0000 Initial Comments Memo
L0509 Exercise Of Rights/Respect For Proprty/Person Standard
L0538 Idg, Care Planning, Coordination Of Services Standard
L0684 Discharge Or Transfer Of Care Standard
▼ 241582 Minnesota Hospice Llc 17645 Juniper Path Suite 155 Lakeville MN 5 (Chicago) 09/18/2024 State Agency 63E03-H1 Complaint, Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments Memo
L0000 Initial Comments Memo
L0545 Content Of Plan Of Care Standard
L0547 Content Of Plan Of Care Standard
L0555 Coordination Of Services Standard