S&C QCOR Hospice 2567s
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Hospice 2567s
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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
▼ 161583 St. Croix Hospice, Llc 1555 Se Delaware Suite Q Ankeny IA 7 (Kansas City) 03/29/2023 5F4E8-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
L0000 Initial Comments Memo
L0536 Idg, Care Planning, Coordination Of Services Condition
L0554 Coordination Of Services Standard
▼ 161583 St. Croix Hospice, Llc 1555 Se Delaware Suite Q Ankeny IA 7 (Kansas City) 07/17/2023 602E9-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
L0000 Initial Comments Memo
L0536 Idg, Care Planning, Coordination Of Services Condition
L0543 Plan Of Care Standard
L0686 Drugs Biologicals Medical Supplies & Dme Condition
L0690 Ordering Of Drugs Standard
L0694 Label Dispose Storage Drugs Standard
L0697 Label Dispose Storage Drugs Standard
L0797 Federal, State, Local Laws & Regulations Condition
▼ 161583 St. Croix Hospice, Llc 1555 Se Delaware Suite Q Ankeny IA 7 (Kansas City) 04/11/2024 62993-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
L0000 Initial Comments Memo
L0520 Initial & Comprehensive Assessment Of Patient Condition
L0533 Update Of Comprehensive Assessment Standard
L0549 Content Of Plan Of Care Standard
▼ 161586 Iowa Hospice, Llc 1370 Lake Street Spirit Lake IA 7 (Kansas City) 11/23/2021 1118073 Initial
Deficiency Tag Deficiency Description Tag Type
L0530 Content Of Comprehensive Assessment Standard
L0545 Content Of Plan Of Care Standard
L0549 Content Of Plan Of Care Standard
L0553 Review Of The Plan Of Care Standard
L0579 Prevention Standard
L0625 Hospice Aide Assignments And Duties Standard
▼ 161586 Iowa Hospice, L L C 1370 Lake Street Spirit Lake IA 7 (Kansas City) 03/06/2023 5F0A0-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
L0000 Initial Comments Memo
L0500 Patients' Rights Condition
L0512 Rights Of The Patient Standard
▼ 161587 Wesley Community Services, Inc. 4328 114th Street Urbandale IA 7 (Kansas City) 03/21/2022 O8J811 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments Memo
L0000 Initial Comments Memo
L0504 Notice Of Rights And Responsibilities Standard
L0530 Content Of Comprehensive Assessment Standard
L0536 Idg, Care Planning, Coordination Of Services Condition
L0543 Plan Of Care Standard
L0545 Content Of Plan Of Care Standard
L0547 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
L0555 Coordination Of Services Standard
L0596 Counseling Services Standard
L0607 Hospice Aide And Homemaker Services Condition
L0615 Competency Evaluation Standard
L0625 Hospice Aide Assignments And Duties Standard
L0626 Hospice Aide Assignments And Duties Standard
L0671 Clinical Records Standard
L0678 Content Standard
L0679 Authentication Standard
L0692 Administration Of Drugs And Biologicals Standard
L0697 Label Dispose Storage Drugs Standard
L0774 Hospice Plan Of Care Standard
L0778 Coordination Of Services Standard
L0781 Coordination Of Services Standard
▼ 161587 Wesley Community Services, Inc. 4328 114th Street Urbandale IA 7 (Kansas City) 02/26/2025 65474-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments Memo
L0000 Initial Comments Memo
L0547 Content Of Plan Of Care Standard
L0554 Coordination Of Services Standard
L0555 Coordination Of Services Standard
L0556 Coordination Of Services Standard
L0613 Hospice Aide Training Standard
L0615 Competency Evaluation Standard
L0626 Hospice Aide Assignments And Duties Standard
L0629 Supervision Of Hospice Aides Standard
L0633 Supervision Of Hospice Aides Standard
L0679 Authentication Standard
L0796 Criminal Background Checks Standard
L0797 Federal, State, Local Laws & Regulations Condition
▼ 161591 Evangelical Lutheran Good Samaritan Society 2035 Chester Ave Ottumwa IA 7 (Kansas City) 12/08/2021 ZES411 Complaint
Deficiency Tag Deficiency Description Tag Type
L0000 Initial Comments Memo
L0538 Idg, Care Planning, Coordination Of Services Standard
L0549 Content Of Plan Of Care Standard
▼ 161591 Evangelical Lutheran Good Samaritan Society 2035 Chester Ave Ottumwa IA 7 (Kansas City) 06/08/2023 5FAC0-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments Memo
L0000 Initial Comments Memo
L0503 Notice Of Rights And Responsibilities Standard
L0530 Content Of Comprehensive Assessment Standard
L0533 Update Of Comprehensive Assessment Standard
L0596 Counseling Services Standard
L0613 Hospice Aide Training Standard
L0625 Hospice Aide Assignments And Duties Standard
L0626 Hospice Aide Assignments And Duties Standard
L0633 Supervision Of Hospice Aides Standard
L0679 Authentication Standard
L0781 Coordination Of Services Standard
▼ 161592 Care Initiatives, Inc 4301 Sergeant Road, Suite 110 Sioux City IA 7 (Kansas City) 09/27/2023 611EE-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments Memo
L0000 Initial Comments Memo
L0530 Content Of Comprehensive Assessment Standard
L0554 Coordination Of Services Standard
L0625 Hospice Aide Assignments And Duties Standard
L0696 Label Dispose Storage Drugs Standard
L0778 Coordination Of Services Standard