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Mother Theresa's Home Health Services

(818) 505-9099847 N. Hollywood Way, # 203, Burbank, CA 91505
CMS Certification Number 058224 · Proprietary · Medicare-certified since 11/17/2003
10deficiencies since 2018
0serious
2inspections
4CMS 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 2022-02-27

· Recertification · 7 deficiencies · CMS source report (PDF)
Moderate Home Health Aide Assignments And Duties

The agency failed to ensure a Registered Nurse (RN) provided written patient care instruction to the certified home health aide (CHHA) for one of 7 sampled patients (Patient 6).

Source: CMS Form 2567, inspection 2022-02-27, tag G0798 · view on CMS
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Minor Eligibility For Medicare Home Health Benefit

The Home Health Agency (HHA) failed to assess the patient's continuing need for skilled nursing services for one of seven sampled patients.

Source: CMS Form 2567, inspection 2022-02-27, tag G0522 · view on CMS
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Minor A Review Of All Current Medications

The home health agency (HHA) nurse failed to review all of medications keeping at the patients' home and update the medication profile for two of 7 sampled patients (Patients 5 and 6).

Source: CMS Form 2567, inspection 2022-02-27, tag G0536 · view on CMS
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Minor Only As Ordered By A Physician

The licensed staff failed to follow the physician's order for one of seven sampled patients (Patient 2) who had open wound to her left breast.

Source: CMS Form 2567, inspection 2022-02-27, tag G0580 · view on CMS
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Minor Other Pertinent Instructions

The Home Health Agency (HHA) failed to provide education/instruction about the correct use of the glucometer for one of 7 sampled patients (Patient 5).

Source: CMS Form 2567, inspection 2022-02-27, tag G0620 · view on CMS
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Minor Provide Services In The Plan Of Care

The home health agency (HHA) failed to follow the plan of care (POC) for one of seven sampled patients (Patient 2) by not assessing the patient's skin on the left breast wound.

Source: CMS Form 2567, inspection 2022-02-27, tag G0710 · view on CMS
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Minor Onsite Supervisory Visit Every 14 Days

The Home Health Agency (HHA) failed to ensure supervisory visit of Certified Home Health Aide (CHHA) was made to the patient's house no less than every 14 days for one of 7 sampled patients (Patient 6).

Source: CMS Form 2567, inspection 2022-02-27, tag G0808 · view on CMS
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Inspection 2018-08-31

· Recertification · 3 deficiencies · CMS source report (PDF)
Moderate Update Of The Comprehensive Assessment

The home health agency (HHA) failed to ensure the comprehensive assessment was updated for two of seven patients (Patients 2 and 3) who suffered serious head injuries from falls at home.

Source: CMS Form 2567, inspection 2018-08-31, tag G0544 · view on CMS
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Minor Make Efforts To Resolve The Problem(S)

The Home Health Agency (HHA) failed to make an effort to investigate and ensure that their policy to protect the patient from injury was followed for one of seven sample patients.

Source: CMS Form 2567, inspection 2018-08-31, tag G0466 · view on CMS
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Minor Provide Services In The Plan Of Care

The agency staff failed to ensure the skilled nursing staff and physical therapy evaluated the pain level as indicated in the plan of care for two of seven sample patients ( Patient 6 and 7).

Source: CMS Form 2567, inspection 2018-08-31, tag G0710 · view on CMS
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