S&C QCOR HHA 2567s
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HHAs 2567s
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Time Interval

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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 HHA 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 and Facility Name

Use these filters if you know the name (or partial name) of the facility you are searching for, or the CMS Certification Number (CCN) for the facility you are searching for.

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
▼ 147034 Egyptian Health Department 1412 Us Hwy 45 N Eldorado IL 5 (Chicago) 01/24/2025 65017-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0680 Infection prevention and control Condition
▼ 147034 Egyptian Health Department 1412 Us Hwy 45 N Eldorado IL 5 (Chicago) 02/02/2022 3819B-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0412 Written notice of patient's rights Element
▼ 147052 County Of Calhoun 210 French Street P O Box 158 Hardin IL 5 (Chicago) 08/07/2024 63CAD-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
▼ 147052 County Of Calhoun 210 French Street P O Box 158 Hardin IL 5 (Chicago) 08/04/2021 54H711 Focused Infection Control, Other-Fed, Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0536 A review of all current medications Element
▼ 147063 Jersey County Health Dept 1307 State Highway 109 Jerseyville IL 5 (Chicago) 03/28/2024 624BC-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0536 A review of all current medications Element
▼ 147063 Jersey County Health Dept 1307 State Highway 109 Jerseyville IL 5 (Chicago) 03/25/2021 HT1X11 Focused Infection Control, Other-Fed, Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0528 Health, psychosocial, functional, cognition Element
▼ 147065 Pike County Health Department 606 W Adams Street Pittsfield IL 5 (Chicago) 02/23/2024 61C0E-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0004 Develop EP Plan, Review and Update Annually Standard
G0572 Plan of care Standard
G0798 Home health aide assignments and duties Standard
G1024 Authentication Standard
▼ 147065 Pike County Health Department 606 W Adams Street Pittsfield IL 5 (Chicago) 01/18/2018 TQKO11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0682 Infection Prevention Standard
G0584 Verbal orders Element
▼ 147075 Henry County Health Department 4424 U.S. Highway 34 Kewanee IL 5 (Chicago) 01/30/2020 B20I11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G1010 Contents of clinical record Standard
G0606 Integrate all services Element
▼ 147086 Clay Home Health Services 601 East Twelfth Street Flora IL 5 (Chicago) 10/20/2023 61111-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0468 Provide contact info other services Element
G0580 Only as ordered by a physician Element