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
▼ 147530 Spoon River Home Health Services 48 N East St Farmington IL 5 (Chicago) 10/22/2021 1970F-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
G0578 Conformance with physician orders Standard
G0576 All orders recorded in plan of care Element
G0718 Communication with physicians Element
▼ 147530 Spoon River Home Health Services 48 N East St Farmington IL 5 (Chicago) 12/14/2018 1DTB11 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
E0013 Development of EP Policies and Procedures Standard
E0019 Homebound HHA/Hospice Inform EP Officials Standard
E0030 Names and Contact Information Standard
E0031 Emergency Officials Contact Information Standard
E0037 EP Training Program Standard
G0682 Infection Prevention Standard
G0684 Infection control Standard
G1024 Authentication Standard
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0616 Patient medication schedule/instructions Element
G0710 Provide services in the plan of care Element
▼ 147536 Option Care Enterprises, Inc 870 North Arlington Hts Road, Suite 102 Itasca IL 5 (Chicago) 01/21/2021 KRMF11 Focused Infection Control, Other-Fed, Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
E0017 HHA Comprehensive Assessment in Disaster Standard
G0550 At discharge Element
G0574 Plan of care must include the following Element
▼ 147545 Caring Professionals Home Care 3450 - 3456 W Peterson Avenue Chicago IL 5 (Chicago) 02/19/2026 1E297D-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0013 Development of EP Policies and Procedures Standard
E0037 EP Training Program Standard
▼ 147559 Rest Haven Illiana Christian Convalescent Home 18601 N Creek Drive Tinley Park IL 5 (Chicago) 02/25/2026 1E299D-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
G0580 Only as ordered by a physician Element
G0582 Influenza and pneumococcal vaccines Element
G0606 Integrate all services Element
▼ 147559 Rest Haven Illiana Christian Convalescent Home 18601 N Creek Drive Tinley Park IL 5 (Chicago) 11/04/2022 5E277-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0578 Conformance with physician orders Standard
G0574 Plan of care must include the following Element
G0582 Influenza and pneumococcal vaccines Element
▼ 147559 Rest Haven Illiana Christian Convalescent Home 18601 N Creek Drive Tinley Park IL 5 (Chicago) 01/10/2020 RWJU11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0808 Onsite supervisory visit every 14 days Element
G1012 Required items in clinical record Element
▼ 147561 Oracle Healthcare Inc 2604 Dempster Street, Ste 202 Park Ridge IL 5 (Chicago) 12/01/2022 5E2BE-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
E0030 Names and Contact Information Standard
G0572 Plan of care Standard
G1024 Authentication Standard
G0514 RN performs assessment Element
G0582 Influenza and pneumococcal vaccines Element
G1022 Discharge and transfer summaries Element
▼ 147562 Cgh Home Nursing 3010 E Lynn Blvd Suite B Sterling IL 5 (Chicago) 08/04/2023 60A1F-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0578 Conformance with physician orders Standard
▼ 147562 Cgh Home Nursing 3010 E Lynn Blvd Suite B Sterling IL 5 (Chicago) 09/17/2020 KJR611 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
G0564 Discharge or Transfer Summary Content Standard
G1024 Authentication Standard