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
▼ 147729 Granite City Home Care Services, Llc 2421 Corporate Center, Suite 101 Granite City IL 5 (Chicago) 04/27/2022 387CB-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0600 Coordination of Care Standard
▼ 147729 Granite City Home Care Services, Llc 2421 Corporate Center, Suite 101 Granite City IL 5 (Chicago) 10/03/2018 91R311 Recertification, Sample Validation
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0578 Conformance with physician orders Standard
▼ 147733 Superior Home Health Llc 10700 W. Higgins Road Suite 310 Rosemont IL 5 (Chicago) 12/08/2023 61A46-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0037 EP Training Program Standard
G0578 Conformance with physician orders Standard
G0808 Onsite supervisory visit every 14 days Element
G1012 Required items in clinical record Element
▼ 147733 Superior Home Health Llc 10700 W. Higgins Road Suite 310 Rosemont IL 5 (Chicago) 01/07/2021 IQQE11 Focused Infection Control, Other-Fed, Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0030 Names and Contact Information Standard
G0682 Infection Prevention Standard
G0684 Infection control Standard
G1024 Authentication Standard
G0514 RN performs assessment Element
G0574 Plan of care must include the following Element
G0580 Only as ordered by a physician Element
G0800 Services provided by HH aide Element
▼ 147734 Able Home Health, Llc 1946 Daimler Road Rockford IL 5 (Chicago) 11/18/2022 5E27B-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
G0578 Conformance with physician orders Standard
G0574 Plan of care must include the following Element
G0582 Influenza and pneumococcal vaccines Element
▼ 147734 Able Home Health, Llc 1946 Daimler Road Rockford IL 5 (Chicago) 01/16/2020 80I311 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0710 Provide services in the plan of care Element
G0808 Onsite supervisory visit every 14 days Element
▼ 147736 We Care Home Health, Inc 2446 W Devon Ave, Ste B Chicago IL 5 (Chicago) 09/19/2025 1D5785-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
E0037 EP Training Program Standard
E0039 EP Testing Requirements Standard
G0372 Encoding and transmitting OASIS Standard
G1024 Authentication Standard
G0434 Participate in care Element
G0484 Document complaint and resolution Element
G0514 RN performs assessment Element
G0574 Plan of care must include the following Element
G0580 Only as ordered by a physician Element
G0582 Influenza and pneumococcal vaccines Element
G0588 Reviewed, revised by physician every 60 days Element
G0590 Promptly alert relevant physician of changes Element
G0622 Name/contact information of clinical manager Element
G0808 Onsite supervisory visit every 14 days Element
G0950 Ensure clinical manager is available Element
G1022 Discharge and transfer summaries Element
▼ 147736 We Care Home Health, Inc 2446 W Devon Ave, Ste B Chicago IL 5 (Chicago) 06/09/2022 4EB08-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
E0004 Develop EP Plan, Review and Update Annually Standard
E0006 Plan Based on All Hazards Risk Assessment Standard
E0029 Development of Communication Plan Standard
E0030 Names and Contact Information Standard
E0033 Methods for Sharing Information Standard
G0452 Transfer and discharge Standard
G0684 Infection control Standard
G0414 HHA administrator contact information Element
G0434 Participate in care Element
G0444 State toll free HH telephone hotline Element
G0514 RN performs assessment Element
G0546 Last 5 days of every 60 days unless: Element
G0588 Reviewed, revised by physician every 60 days Element
G0622 Name/contact information of clinical manager Element
G0710 Provide services in the plan of care Element
G1022 Discharge and transfer summaries Element
▼ 147736 We Care Home Health, Inc 2446 W Devon Ave, Ste B Chicago IL 5 (Chicago) 05/28/2020 YOED11 Focused Infection Control, Other-Fed
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0684 Infection control Standard
G0686 Infection control education Standard
▼ 147739 Medtec Home Health Agency, Inc. 10001 W Roosevelt Rd, Ste 209 Westchester IL 5 (Chicago) 05/31/2024 62F9B-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0037 EP Training Program Standard
G0372 Encoding and transmitting OASIS Standard
G0434 Participate in care Element
G0582 Influenza and pneumococcal vaccines Element
G0622 Name/contact information of clinical manager Element