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
147955 St Rita Home Health Care, Inc 5105 Tollview Dr, Ste 101 Rolling Mdws IL 5 (Chicago) 08/19/2021 4GXR11 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
G1024 Authentication Standard
G1022 Discharge and transfer summaries Element
147956 Mjm Health Agency, Inc 1s311 Summit Ave Oakbrook Terrace IL 5 (Chicago) 11/22/2024 64827-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
G0850 Disclosure of ownership and management info. Standard
G1024 Authentication Standard
G0434 Participate in care Element
G0574 Plan of care must include the following Element
G0622 Name/contact information of clinical manager Element
G0710 Provide services in the plan of care Element
G1022 Discharge and transfer summaries Element
147956 Mjm Health Agency, Inc 1s311 Summit Ave Oakbrook Terrace IL 5 (Chicago) 10/07/2021 196BE-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0710 Provide services in the plan of care Element
147958 Healthcare Partners At Home, Llc 6316 N Lincoln Ave Unit 2 Chicago IL 5 (Chicago) 08/09/2024 63BAD-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
147958 Healthcare Partners At Home, Llc 6316 N Lincoln Ave Unit 2 Chicago IL 5 (Chicago) 07/16/2021 KC6011 Focused Infection Control, Other-Fed, Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0852 Information to the state survey agency Standard
147960 Primecare Home Health Services, Inc 7383 North Lincoln Avenue, Suite 120 Lincolnwood IL 5 (Chicago) 07/26/2024 63731-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
147960 Primecare Home Health Services, Inc 7383 North Lincoln Avenue, Suite 120 Lincolnwood IL 5 (Chicago) 06/24/2021 Y75O11 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
G1014 Interventions and patient response Element
147960 Primecare Home Health Services, Inc 7383 North Lincoln Avenue, Suite 120 Lincolnwood IL 5 (Chicago) 06/15/2018 9NO611 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
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
147963 4ever Care Home Health Services Inc 2015 South Arlington Heights Road Suite 102 Arlington Heights IL 5 (Chicago) 12/07/2018 S58511 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0710 Provide services in the plan of care Element
G1012 Required items in clinical record Element
147964 Humanity Home Health Llc 450 E 22nd St, Ste 217 Lombard IL 5 (Chicago) 06/28/2024 632FE-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
G0550 At discharge Element
G0710 Provide services in the plan of care Element
G1022 Discharge and transfer summaries Element