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
▼ 147601 Prime Care Resource, Inc 9406 Waukegan Rd Morton Grove IL 5 (Chicago) 01/08/2021 V2S011 Focused Infection Control, Other-Fed, Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
E0039 EP Testing Requirements Standard
G0710 Provide services in the plan of care Element
▼ 147602 Vital Home & Healthcare Inc. 8051 A West 186th Street Tinley Park IL 5 (Chicago) 05/31/2024 62F98-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0030 Names and Contact Information Standard
E0039 EP Testing Requirements Standard
G0572 Plan of care Standard
G0514 RN performs assessment Element
G0574 Plan of care must include the following Element
G0582 Influenza and pneumococcal vaccines Element
G0590 Promptly alert relevant physician of changes Element
▼ 147602 Vital Home & Healthcare Inc. 8051 A West 186th Street Tinley Park IL 5 (Chicago) 01/25/2022 38322-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0562 Discharge Planning Standard
G0606 Integrate all services Element
G0710 Provide services in the plan of care Element
▼ 147602 Vital Home & Healthcare Inc. 8051 A West 186th Street Tinley Park IL 5 (Chicago) 05/21/2021 FHEF11 Focused Infection Control, Other-Fed, Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0710 Provide services in the plan of care Element
▼ 147602 Vital Home & Healthcare Inc. 8051 A West 186th Street Tinley Park IL 5 (Chicago) 04/20/2018 UT5I11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0590 Promptly alert relevant physician of changes Element
G1022 Discharge and transfer summaries Element
▼ 147606 Quality Home Care Services Lt 3510 West 79th Street Chicago IL 5 (Chicago) 06/01/2023 5FEB3-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
▼ 147611 Galesburg Home Care Llc 1865 N Henderson St, Suite 11b Galesburg IL 5 (Chicago) 04/22/2022 387A6-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0578 Conformance with physician orders Standard
G0682 Infection Prevention Standard
G0798 Home health aide assignments and duties Standard
G0574 Plan of care must include the following Element
G0606 Integrate all services Element
G0706 Interdisciplinary assessment of the patient Element
▼ 147612 Fairfield Memorial Hospital Association 303 North West 11th Street Fairfield IL 5 (Chicago) 03/16/2023 5F102-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0516 Skilled professional performs assessment Element
▼ 147612 Fairfield Memorial Hospital Association 303 North West 11th Street Fairfield IL 5 (Chicago) 03/11/2020 SI3T11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0598 Discharge plans communication Element
▼ 147618 Covenant Home Services 3755 East Main Ave, Ste 165 Saint Charles IL 5 (Chicago) 02/07/2025 64F80-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0372 Encoding and transmitting OASIS Standard
G1024 Authentication Standard