S&C QCOR HHA 2567s
d QCOR:  Quality, Certification and Oversight Reports.
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
147766 5 Star Healthcare, Inc 2093 Rand Rd, Suite Ll Des Plaines IL 5 (Chicago) 01/28/2021 6YY611 Focused Infection Control, Other-Fed, Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0414 HHA administrator contact information Element
G0422 Written notice within 4 business days Element
147768 Golden Haven Care, Inc 6525 W North Avenue, Suite 107 Oak Park IL 5 (Chicago) 11/07/2024 64823-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
G0550 At discharge Element
G0582 Influenza and pneumococcal vaccines Element
147768 Golden Haven Care, Inc 6525 W North Avenue, Suite 107 Oak Park IL 5 (Chicago) 09/24/2021 19656-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G1014 Interventions and patient response Element
147769 Advance Home Health Care, Ltd 5948 N Milwaukee Ave Chicago IL 5 (Chicago) 09/26/2025 1D579E-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
G0572 Plan of care Standard
G1024 Authentication Standard
G0574 Plan of care must include the following Element
147769 Advance Home Health Care, Ltd 5948 N Milwaukee Ave Chicago IL 5 (Chicago) 08/25/2022 4F18C-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
E0030 Names and Contact Information Standard
G0682 Infection Prevention Standard
G0514 RN performs assessment Element
G0580 Only as ordered by a physician Element
G0608 Coordinate care delivery Element
147769 Advance Home Health Care, Ltd 5948 N Milwaukee Ave Chicago IL 5 (Chicago) 03/25/2022 38695-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0578 Conformance with physician orders Standard
147769 Advance Home Health Care, Ltd 5948 N Milwaukee Ave Chicago IL 5 (Chicago) 10/18/2019 5ADI11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
E0017 HHA Comprehensive Assessment in Disaster Standard
147772 Advanced Homecare, Inc 8320 South Lemont Road Darien IL 5 (Chicago) 11/19/2020 8XQ811 Focused Infection Control, Other-Fed, Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G1024 Authentication Standard
147773 Life Plus Hoealth Care, Inc 2714 West Peterson Street, 1st Floor Chicago IL 5 (Chicago) 09/27/2022 4F188-H2 Recertification
Deficiency Tag Deficiency Description Tag Type
G0572 Plan of care Standard
G0687 COVID-19 Vaccination of Home Health Agency staff Standard
G1014 Interventions and patient response Element
147773 Life Plus Hoealth Care, Inc 2714 West Peterson Street, 1st Floor Chicago IL 5 (Chicago) 08/02/2022 4F188-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0940 Organization and administration of services Condition
G0958 Clinical manager Standard