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

Time Interval

Please select the calendar year or years for which you would like data.

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
147086 Clay Home Health Services 601 East Twelfth Street Flora IL 5 (Chicago) 09/23/2020 7S3011 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
G0572 Plan of care Standard
G0686 Infection control education Standard
147088 Ssm Health Businesses 1501 Mcpherson Avenue Mount Vernon IL 5 (Chicago) 02/28/2024 6210D-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0039 EP Testing Requirements Standard
G0514 RN performs assessment Element
G0536 A review of all current medications Element
G0580 Only as ordered by a physician Element
147088 Ssm Health Businesses 1501 Mcpherson Avenue Mount Vernon IL 5 (Chicago) 03/11/2021 G52K11 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
G0654 Track adverse patient events Standard
G0682 Infection Prevention Standard
G0718 Communication with physicians Element
147088 Ssm Health Businesses 1501 Mcpherson Avenue Mount Vernon IL 5 (Chicago) 03/29/2018 KJQU11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0750 Home health aide services Condition
G0752 Home health aide qualifications Standard
G0754 A qualified HH aide successfully completed: Element
G0786 Unqualified HH aide providing services Element
147091 Greene County Health Dept 310 Fifth Street Carrollton IL 5 (Chicago) 06/23/2021 IWXS11 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
G0686 Infection control education Standard
147105 Prime Healthcare Home Care And Hospice, Llc 555 West Court Street Kankakee IL 5 (Chicago) 07/31/2025 66818-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0444 State toll free HH telephone hotline Element
147105 Prime Healthcare Home Care And Hospice, Llc 555 West Court Street Kankakee IL 5 (Chicago) 06/30/2022 4EBCE-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0682 Infection Prevention Standard
G0706 Interdisciplinary assessment of the patient Element
G0710 Provide services in the plan of care Element
147105 Prime Healthcare Home Care And Hospice, Llc 555 West Court Street Kankakee IL 5 (Chicago) 08/01/2019 31L611 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0017 HHA Comprehensive Assessment in Disaster Standard
G0572 Plan of care Standard
G0798 Home health aide assignments and duties Standard
G0484 Document complaint and resolution Element
G0574 Plan of care must include the following Element
G0576 All orders recorded in plan of care Element
G0606 Integrate all services Element
G1012 Required items in clinical record Element
147113 Osf Healthcare System 228 Alton Square Parkway Alton IL 5 (Chicago) 08/01/2025 66819-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
147113 Osf Healthcare System 228 Alton Square Parkway Alton IL 5 (Chicago) 10/20/2022 4F7B3-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0562 Discharge Planning Standard
G0602 Communication with all physicians Element
G0606 Integrate all services Element