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Supreme Home Health Agency Inc

(951) 972-30387177 Brockton Ave., Suite 451, Riverside, CA 92506
CMS Certification Number 059566 · Proprietary · Medicare-certified since 03/06/2013
6deficiencies since 2018
0serious
1inspections
2CMS quality stars
Data from CMS inspection reports (Form 2567), 2018-01-02 to 2026-10-15, downloaded 2026-10-21; CMS agency list file dated 2026-09-21. What the labels mean

Inspection 2024-02-29

· Recertification · 6 deficiencies · CMS source report (PDF)
Moderate Encoding And Transmitting Oasis

The agency failed to ensure OASIS (Outcome and Assessment Information Set – patient specific information used in Medicare to determine reimbursement and measure quality) data (facts collected for analysis) for patient assessments was transmitted to CMS (Center for Medicare and Medicaid Services)…

Source: CMS Form 2567, inspection 2024-02-29, tag G0372 · view on CMS
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Moderate Competency Evaluation

The Home Health Agency failed to complete an Initial Assessment Skills Checklist for Certified Home Health Aide 1 (CHHA 1) prior to furnishing in home services on behalf of the Home Health Agency.

Source: CMS Form 2567, inspection 2024-02-29, tag G0768 · view on CMS
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Minor A Review Of All Current Medications

The agency failed to ensure the clinical records contained accurate comprehensive medication profiles, for two of three patients reviewed (Patients 1 and 2), when the medication profiles did not accurately reflect the medications Patients 1 and 2 were taking in the home.

Source: CMS Form 2567, inspection 2024-02-29, tag G0536 · view on CMS
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Minor Verbal Orders

The agency failed to ensure verbal orders were signed within 30 days according to the agency's policy and procedure, for one of seven sampled patients (Patient 7).

Source: CMS Form 2567, inspection 2024-02-29, tag G0584 · view on CMS
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Minor Documentation Of Competency Evaluation

The Home Health Agency failed to conduct an annual Employee Performance Evaluation, for four of four sampled employees (Employees 1, 2, 3, and 4).

Source: CMS Form 2567, inspection 2024-02-29, tag G0772 · view on CMS
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Minor Ensure That Hha Employs Qualified Personnel

The agency failed to ensure the hiring of qualified employees by incomplete employment files for two of five sampled employees (Employees 1 and 2).

Source: CMS Form 2567, inspection 2024-02-29, tag G0952 · view on CMS
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