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
▼ 147832 P W Home Health, Inc 17w662 Butterfield Rd Ste 306 Oakbrook Ter IL 5 (Chicago) 08/08/2024 63B4A-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
G0434 Participate in care Element
▼ 147834 Infinity Home Health Care, Inc 3315 W. Algonquin Rd, Ste 410 Rolling Meadows IL 5 (Chicago) 05/23/2022 4EABB-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G1012 Required items in clinical record Element
▼ 147834 Infinity Home Health Care, Inc 3315 W. Algonquin Rd, Ste 410 Rolling Meadows IL 5 (Chicago) 09/23/2021 19653-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0580 Only as ordered by a physician Element
G0582 Influenza and pneumococcal vaccines Element
▼ 147836 Elc Health Care, Llc 1925 N Harlem Ave Ste #108-109-110 Chicago IL 5 (Chicago) 11/22/2019 1GFS11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
E0006 Plan Based on All Hazards Risk Assessment Standard
E0017 HHA Comprehensive Assessment in Disaster Standard
E0030 Names and Contact Information Standard
E0039 EP Testing Requirements Standard
G0574 Plan of care must include the following Element
G0588 Reviewed, revised by physician every 60 days Element
G1012 Required items in clinical record Element
▼ 147837 Midwest Home Healthcare, Inc. 7820 Graphic Dr., Ste 201 Tinley Park IL 5 (Chicago) 11/07/2019 2DC811 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
E0017 HHA Comprehensive Assessment in Disaster Standard
▼ 147840 Wailai Home Health Services 4554 North Broadway, Suite 312 Chicago IL 5 (Chicago) 04/12/2024 62B80-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
E0039 EP Testing Requirements Standard
▼ 147840 Wailai Home Health Services 4554 North Broadway, Suite 312 Chicago IL 5 (Chicago) 04/23/2021 EHOJ11 Focused Infection Control, Other-Fed, Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
E0006 Plan Based on All Hazards Risk Assessment Standard
E0039 EP Testing Requirements Standard
▼ 147840 Wailai Home Health Services 4554 North Broadway, Suite 312 Chicago IL 5 (Chicago) 03/30/2018 6EB011 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
E0017 HHA Comprehensive Assessment in Disaster Standard
G0572 Plan of care Standard
G0682 Infection Prevention Standard
G0588 Reviewed, revised by physician every 60 days Element
G0716 Preparing clinical notes Element
▼ 147841 Entera Healthcare, Ltd. 10700 W. Higgins Rd, Suite 110 Rosemont IL 5 (Chicago) 02/11/2026 1D82D4-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
E0030 Names and Contact Information Standard
E0039 EP Testing Requirements Standard
G0372 Encoding and transmitting OASIS Standard
G0572 Plan of care Standard
G0850 Disclosure of ownership and management info. Standard
G0414 HHA administrator contact information Element
G0422 Written notice within 4 business days Element
G0582 Influenza and pneumococcal vaccines Element
▼ 147841 Entera Healthcare, Ltd. 10700 W. Higgins Rd, Suite 110 Rosemont IL 5 (Chicago) 10/21/2022 4F7D9-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0578 Conformance with physician orders Standard
G0687 COVID-19 Vaccination of Home Health Agency staff Standard