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
▼ 241614 Healthstar Home Health & Hospice 2701 West Superior St, Suite 101 Duluth MN 5 (Chicago) 07/07/2022 ACHC 44070 Initial
Deficiency Tag Deficiency Description Tag Type
L0596 Counseling Services Standard
L0673 Content Standard
L0900 Covid-19 Vaccination Of Facility Staff Standard
▼ 241615 Suite Living Hospice Care, Llc 1824 Buerkle Road White Bear Lake MN 5 (Chicago) 02/01/2023 CHAP JAN3023_ZHP_8548437_ Initial with CCN
Deficiency Tag Deficiency Description Tag Type
L0625 Hospice Aide Assignments And Duties Standard
L0626 Hospice Aide Assignments And Duties Standard
▼ 241616 Moments Hospice Of Mankato, Llc 124 E Walnut St., Suite 205 Mankato MN 5 (Chicago) 03/02/2023 CHAP FEB2823_LSS_8547622_ Initial
Deficiency Tag Deficiency Description Tag Type
L0523 Timeframe For Completion Of Assessment Standard
▼ 241618 Beyond Hospice 6025 Upper 35th Street North, Oakdale MN 5 (Chicago) 06/23/2023 CHAP JUN2023_CKV_8548693_ Initial
Deficiency Tag Deficiency Description Tag Type
L0530 Content Of Comprehensive Assessment Standard
L0545 Content Of Plan Of Care Standard
L0547 Content Of Plan Of Care Standard
L0549 Content Of Plan Of Care Standard
L0625 Hospice Aide Assignments And Duties Standard
▼ 241619 Lake Valley Hospice Llc 4517 Minnetonka Blvd, 105 St. Louis Park MN 5 (Chicago) 12/07/2023 CHAP DEC0523_EPW_8549023_ Initial
Deficiency Tag Deficiency Description Tag Type
L0545 Content Of Plan Of Care Standard
L0596 Counseling Services Standard
L0625 Hospice Aide Assignments And Duties Standard
L0626 Hospice Aide Assignments And Duties Standard
L0676 Content Standard
L0678 Content Standard
L0682 Discharge Or Transfer Of Care Standard
L0774 Hospice Plan Of Care Standard
▼ 241621 Serenity Hospice Homes Llc 8948 Stratford Ct N Brooklyn Park MN 5 (Chicago) 12/28/2023 ACHC 1281780 Initial
Deficiency Tag Deficiency Description Tag Type
L0523 Timeframe For Completion Of Assessment Standard
L0530 Content Of Comprehensive Assessment Standard
L0549 Content Of Plan Of Care Standard
L0596 Counseling Services Standard
L0626 Hospice Aide Assignments And Duties Standard
L0684 Discharge Or Transfer Of Care Standard
L0784 Personnel Qualification Standard
L0788 Personnel Qualification Standard
L0789 Personnel Qualification Standard
L0791 Personnel Qualification Standard
L0795 Criminal Background Checks Standard
▼ 241622 Bethesda Hospice 1205 Willmar Ave Se, Suite 165 Willmar MN 5 (Chicago) 07/11/2024 CHAP JUL0924_HSG_8549526_ Initial
Deficiency Tag Deficiency Description Tag Type
L0523 Timeframe For Completion Of Assessment Standard
L0530 Content Of Comprehensive Assessment Standard
L0625 Hospice Aide Assignments And Duties Standard
L0678 Content Standard
L0694 Label Dispose Storage Drugs Standard
▼ 241623 Stch Wayzata Mn Llc 13911 Ridgedale Dr, 190 Minnetonka MN 5 (Chicago) 07/24/2024 CHAP JUL2224_DJN_8550149_ Initial with CCN
Deficiency Tag Deficiency Description Tag Type
L0548 Content Of Plan Of Care Standard
▼ 241624 Prairie Grace Hospice, Llc 1028 N. Riverfront Dr. Mankato MN 5 (Chicago) 09/05/2024 ACHC 1241717 Initial
Deficiency Tag Deficiency Description Tag Type
E0025 Arrangement With Other Facilities Standard
E0037 Ep Training Program Standard
L0530 Content Of Comprehensive Assessment Standard
L0547 Content Of Plan Of Care Standard
L0549 Content Of Plan Of Care Standard
L0550 Content Of Plan Of Care Standard
L0555 Coordination Of Services Standard
L0625 Hospice Aide Assignments And Duties Standard
L0676 Content Standard
▼ 241625 Superior Hospice Inc. 800 Boone Avenue North, Suite 194 Golden Valley MN 5 (Chicago) 10/10/2024 CHAP OCT0824_GSX_8550025_ Initial
Deficiency Tag Deficiency Description Tag Type
L0549 Content Of Plan Of Care Standard