S&C QCOR HHA 2567s
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HHAs 2567s
Selection Criteria ▸

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
▼ 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
▼ 147113 Osf Healthcare System 228 Alton Square Parkway Alton IL 5 (Chicago) 12/05/2019 4O9Z11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G1022 Discharge and transfer summaries Element
▼ 147131 Home Health Care Of Ksb Hospital 403 East 1st Street Dixon IL 5 (Chicago) 08/03/2023 609CE-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0006 Plan Based on All Hazards Risk Assessment Standard
E0030 Names and Contact Information Standard
E0039 EP Testing Requirements Standard
G0574 Plan of care must include the following Element
G0582 Influenza and pneumococcal vaccines Element
G0622 Name/contact information of clinical manager Element
G1022 Discharge and transfer summaries Element
▼ 147131 Home Health Care Of Ksb Hospital 403 East 1st Street Dixon IL 5 (Chicago) 09/17/2020 UGDS11 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
G0684 Infection control Standard
G0798 Home health aide assignments and duties Standard
G0414 HHA administrator contact information Element
G0422 Written notice within 4 business days Element
G0446 Contact info Federal/State-funded entities Element
G0574 Plan of care must include the following Element
G0590 Promptly alert relevant physician of changes Element
G0800 Services provided by HH aide Element
▼ 147132 Osf Healthcare System 1501 Interstate Drive Champaign IL 5 (Chicago) 09/11/2025 1D4982-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