S&C QCOR HHA 2567s
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HHAs 2567s
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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
▼ 147851 Metro Home Health Care Nfp 1032 E Ogden Ave Suite 106 Naperville IL 5 (Chicago) 01/30/2025 64F87-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
▼ 147851 Metro Home Health Care Nfp 1032 E Ogden Ave Suite 106 Naperville IL 5 (Chicago) 11/10/2021 37DD4-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0798 Home health aide assignments and duties Standard
G1024 Authentication Standard
G0440 Payment from federally funded programs Element
▼ 147853 Reliable Home Health Care, Inc 3900 W 95th St, Ste 9,10,11 Evergreen Park IL 5 (Chicago) 11/10/2022 5E27C-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
E0013 Development of EP Policies and Procedures Standard
E0029 Development of Communication Plan Standard
E0030 Names and Contact Information Standard
G0572 Plan of care Standard
G0514 RN performs assessment Element
G0580 Only as ordered by a physician Element
G0622 Name/contact information of clinical manager Element
G0710 Provide services in the plan of care Element
G1022 Discharge and transfer summaries Element
▼ 147853 Reliable Home Health Care, Inc 3900 W 95th St, Ste 9,10,11 Evergreen Park IL 5 (Chicago) 01/23/2020 6QQ811 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
E0039 EP Testing Requirements Standard
G0588 Reviewed, revised by physician every 60 days Element
▼ 147854 Chicagoland Home Health Provider, Inc 1974 Miner St Des Plaines IL 5 (Chicago) 12/31/2025 1D82BD-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
G0582 Influenza and pneumococcal vaccines Element
G0810 If concern identified, direct observation Element
▼ 147854 Chicagoland Home Health Provider, Inc 1974 Miner St Des Plaines IL 5 (Chicago) 10/14/2022 4F7D0-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
G0687 COVID-19 Vaccination of Home Health Agency staff Standard
G0514 RN performs assessment Element
G0728 Rehab services supervised by PT, OT Element
G0808 Onsite supervisory visit every 14 days Element
G1014 Interventions and patient response Element
▼ 147855 Care Solutions, Inc 365 Millennium Drive, Ste D Crystal Lake IL 5 (Chicago) 12/30/2022 5E5A9-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G1024 Authentication Standard
G0440 Payment from federally funded programs Element
G0514 RN performs assessment Element
G0582 Influenza and pneumococcal vaccines Element
G0808 Onsite supervisory visit every 14 days Element
▼ 147855 Care Solutions, Inc 365 Millennium Drive, Ste D Crystal Lake IL 5 (Chicago) 02/28/2020 26GT11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
E0039 EP Testing Requirements Standard
G0798 Home health aide assignments and duties Standard
G0574 Plan of care must include the following Element
G0580 Only as ordered by a physician Element
G0808 Onsite supervisory visit every 14 days Element
G0950 Ensure clinical manager is available Element
G0954 Ensures qualified pre-designated person Element
▼ 147859 Accord Home Health Services, Inc 6871 West 171st Street Tinley Park IL 5 (Chicago) 12/16/2022 5E5A1-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
G0578 Conformance with physician orders Standard
G0687 COVID-19 Vaccination of Home Health Agency staff Standard
▼ 147860 Serenity Home Healthcare, Inc 6640 West Touhy Avenue Niles IL 5 (Chicago) 12/06/2024 64C6D-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
G0572 Plan of care Standard
G1024 Authentication Standard
G0414 HHA administrator contact information Element
G0574 Plan of care must include the following Element
G0622 Name/contact information of clinical manager Element
G1022 Discharge and transfer summaries Element