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

Time Interval

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Provider Characteristics

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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
147693 Reliacare Ltd. 1263 S Highland Ave, Unit 2h Lombard IL 5 (Chicago) 01/12/2024 61E97-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
G0574 Plan of care must include the following Element
G0580 Only as ordered by a physician Element
147693 Reliacare Ltd. 1263 S Highland Ave, Unit 2h Lombard IL 5 (Chicago) 06/06/2023 5FF92-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0798 Home health aide assignments and duties Standard
G0944 Administrator must: Standard
G0754 A qualified HH aide successfully completed: Element
147693 Reliacare Ltd. 1263 S Highland Ave, Unit 2h Lombard IL 5 (Chicago) 02/04/2021 EI5D11 Focused Infection Control, Other-Fed, Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
E0001 Establishment of the Emergency Program (EP) Condition
G0570 Care planning, coordination, quality of care Condition
E0004 Develop EP Plan, Review and Update Annually Standard
E0006 Plan Based on All Hazards Risk Assessment Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0030 Names and Contact Information Standard
E0036 EP Training and Testing Standard
G0512 Standard: Initial assessment visit. Standard
G0578 Conformance with physician orders Standard
G0684 Infection control Standard
G1024 Authentication Standard
G0422 Written notice within 4 business days Element
G0550 At discharge Element
G0574 Plan of care must include the following Element
G0582 Influenza and pneumococcal vaccines Element
G0590 Promptly alert relevant physician of changes Element
G0598 Discharge plans communication Element
G0622 Name/contact information of clinical manager Element
G1012 Required items in clinical record Element
G1022 Discharge and transfer summaries Element
147694 At Home Health Care Ste 5 Broadway Plaza Sparta IL 5 (Chicago) 09/22/2023 60D13-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
147697 Progressive Home Health Care 601 Skokie Blvd, Suite 303 Northbrook IL 5 (Chicago) 07/31/2025 66888-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
G0414 HHA administrator contact information Element
G0582 Influenza and pneumococcal vaccines Element
147701 Pearl Health Care Services 1415 West Foster Avenue Chicago IL 5 (Chicago) 01/24/2020 G5TD11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0728 Rehab services supervised by PT, OT Element
G1012 Required items in clinical record Element
147704 Ultimate Home Health Care, Inc 11070 S. Western Avenue Chicago IL 5 (Chicago) 05/02/2025 660A3-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
G0414 HHA administrator contact information Element
G0582 Influenza and pneumococcal vaccines Element
G1022 Discharge and transfer summaries Element
147704 Ultimate Home Health Care, Inc 11070 S. Western Avenue Chicago IL 5 (Chicago) 02/17/2022 3833B-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
E0030 Names and Contact Information Standard
G1024 Authentication Standard
G0434 Participate in care Element
G0582 Influenza and pneumococcal vaccines Element
G0954 Ensures qualified pre-designated person Element
147704 Ultimate Home Health Care, Inc 11070 S. Western Avenue Chicago IL 5 (Chicago) 03/20/2019 IK4E11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
E0017 HHA Comprehensive Assessment in Disaster Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0032 Primary/Alternate Means for Communication Standard
G0484 Document complaint and resolution Element
G0514 RN performs assessment Element
G0574 Plan of care must include the following Element
147706 Caring Touch, Inc. 10700 W. Higgins Road Ste 320 Rosemont IL 5 (Chicago) 05/07/2026 230A08-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
G0372 Encoding and transmitting OASIS Standard
G0434 Participate in care Element
G0514 RN performs assessment Element
G0574 Plan of care must include the following Element
G0622 Name/contact information of clinical manager Element
G1022 Discharge and transfer summaries Element