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

Time Interval

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Note: Hospice 2567s data begin starting October 2021.

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.

CMS Certification Number Facility Name Address City State CMS Region Date of CMS Survey Survey Event ID Survey Type Statement of Deficiencies Report
151575 Viaquest Hospice Of Indiana, Llc 724 West Navajo Street West Lafayette IN 5 (Chicago) 05/19/2022 B71E11 Complaint
Deficiency Tag Deficiency Description Tag Type
L0000 Initial Comments Memo
L0520 Initial & Comprehensive Assessment Of Patient Condition
L0524 Content Of Comprehensive Assessment Standard
L0533 Update Of Comprehensive Assessment Standard
L0536 Idg, Care Planning, Coordination Of Services Condition
L0539 Approach To Service Delivery Standard
L0543 Plan Of Care Standard
L0554 Coordination Of Services Standard
L0591 Nursing Services Standard
L0651 Governing Body And Administrator Standard
L0662 Training Standard
151575 Viaquest Hospice Of Indiana, Llc 724 West Navajo Street West Lafayette IN 5 (Chicago) 07/02/2024 6368B-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments Memo
E0006 Plan Based On All Hazards Risk Assessment Standard
E0007 Ep Program Patient Population Standard
E0009 Local, State, Tribal Collaboration Process Standard
L0000 Initial Comments Memo
L0524 Content Of Comprehensive Assessment Standard
L0533 Update Of Comprehensive Assessment Standard
L0534 Patient Outcome Measures Standard
L0535 Patient Outcome Measures Standard
L0536 Idg, Care Planning, Coordination Of Services Condition
L0545 Content Of Plan Of Care Standard
L0548 Content Of Plan Of Care Standard
L0549 Content Of Plan Of Care Standard
L0550 Content Of Plan Of Care Standard
L0553 Review Of The Plan Of Care Standard
L0557 Coordination Of Services Standard
L0579 Prevention Standard
L0774 Hospice Plan Of Care Standard
151577 Guardian Angel Hospice Inc 513 W Lincoln Rd Kokomo IN 5 (Chicago) 03/22/2024 61F9C-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments Memo
E0018 Procedures For Tracking Of Staff And Patients Standard
L0000 Initial Comments Memo
L0547 Content Of Plan Of Care Standard
L0549 Content Of Plan Of Care Standard
L0552 Review Of The Plan Of Care Standard
L0625 Hospice Aide Assignments And Duties Standard
L0626 Hospice Aide Assignments And Duties Standard
L0629 Supervision Of Hospice Aides Standard
L0703 Use & Maintenance Of Equipment & Supplies Standard
L0762 Professional Management Standard
151580 Hospice Of Darke County, Inc. 743 E Washington Street Winchester IN 5 (Chicago) 08/12/2022 DMEO11 Complaint, Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments Memo
L0000 Initial Comments Memo
L0587 Core Services Condition
L0591 Nursing Services Standard
151582 Southerncare Inc 1626 E Day Rd Mishawaka IN 5 (Chicago) 05/26/2022 2CUK11 Complaint
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments Memo
L0000 Initial Comments Memo
L0505 Exercise Of Rights/Respect For Proprty/Person Standard
151582 Southerncare Inc 1626 E Day Rd Mishawaka IN 5 (Chicago) 09/28/2022 GSMH11 Complaint
Deficiency Tag Deficiency Description Tag Type
L0000 Initial Comments Memo
L0500 Patients' Rights Condition
L0511 Exercise Of Rights/Respect For Proprty/Person Standard
L0517 Rights Of The Patient Standard
L0536 Idg, Care Planning, Coordination Of Services Condition
L0548 Content Of Plan Of Care Standard
L0549 Content Of Plan Of Care Standard
L0552 Review Of The Plan Of Care Standard
L0554 Coordination Of Services Standard
151582 Southerncare, Inc. 1626 E. Day Road Mishawaka IN 5 (Chicago) 09/29/2023 1188451 Reaccreditation
Deficiency Tag Deficiency Description Tag Type
L0523 Timeframe For Completion Of Assessment Standard
L0530 Content Of Comprehensive Assessment Standard
L0531 Content Of Comprehensive Assessment Standard
L0549 Content Of Plan Of Care Standard
L0550 Content Of Plan Of Care Standard
L0555 Coordination Of Services Standard
L0579 Prevention Standard
L0615 Competency Evaluation Standard
L0626 Hospice Aide Assignments And Duties Standard
L0673 Content Standard
L0677 Content Standard
L0679 Authentication Standard
L0787 Personnel Qualification Standard
151582 Southerncare Inc 1626 E Day Rd Mishawaka IN 5 (Chicago) 11/28/2023 60FEB-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
L0000 Initial Comments Memo
L0512 Rights Of The Patient Standard
L0520 Initial & Comprehensive Assessment Of Patient Condition
L0524 Content Of Comprehensive Assessment Standard
L0533 Update Of Comprehensive Assessment Standard
L0544 Plan Of Care 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
L0556 Coordination Of Services Standard
L0557 Coordination Of Services Standard
L0559 Quality Assessment & Performance Improvement Condition
L0579 Prevention Standard
L0591 Nursing Services Standard
L0655 Professional Management Responsibility Standard
L0674 Content Standard
151582 Southerncare Inc 1626 E Day Rd Mishawaka IN 5 (Chicago) 01/19/2024 60FEB-H2 Complaint
Deficiency Tag Deficiency Description Tag Type
L0000 Initial Comments Memo
L0533 Update Of Comprehensive Assessment Standard
L0545 Content Of Plan Of Care Standard
L0549 Content Of Plan Of Care Standard
L0550 Content Of Plan Of Care Standard
L0556 Coordination Of Services Standard
L0557 Coordination Of Services Standard
L0591 Nursing Services Standard
L0625 Hospice Aide Assignments And Duties Standard
L0626 Hospice Aide Assignments And Duties Standard
151582 Southerncare Inc 1626 E Day Rd Mishawaka IN 5 (Chicago) 02/20/2024 62431-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
L0000 Initial Comments Memo
L0585 Licensed Professional Services Standard