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
▼ 147964 Humanity Home Health Llc 450 E 22nd St, Ste 217 Lombard IL 5 (Chicago) 06/28/2018 ENRV11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
E0001 Establishment of the Emergency Program (EP) Condition
E0004 Develop EP Plan, Review and Update Annually Standard
E0013 Development of EP Policies and Procedures Standard
E0029 Development of Communication Plan Standard
E0036 EP Training and Testing Standard
▼ 147966 Holistic Health Partners, Inc 2340 S River Road Ste 110 Des Plaines IL 5 (Chicago) 10/24/2024 64498-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0004 Develop EP Plan, Review and Update Annually Standard
E0013 Development of EP Policies and Procedures Standard
G0372 Encoding and transmitting OASIS Standard
G0572 Plan of care Standard
G0582 Influenza and pneumococcal vaccines Element
▼ 147966 Holistic Health Partners, Inc 2340 S River Road Ste 110 Des Plaines IL 5 (Chicago) 09/02/2021 EHOM11 Focused Infection Control, Other-Fed, Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0684 Infection control Standard
G0574 Plan of care must include the following Element
▼ 147967 Med Plus Home Healthcare, Llc 4440 W Lincoln Hwy, Suite 111 Matteson IL 5 (Chicago) 04/28/2022 3899B-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0680 Infection prevention and control Condition
G0940 Organization and administration of services Condition
E0030 Names and Contact Information Standard
G0572 Plan of care Standard
G0687 COVID-19 Vaccination of Home Health Agency staff Standard
G1024 Authentication Standard
G0418 Patient's or legal representative's signature Element
G0434 Participate in care Element
G0440 Payment from federally funded programs Element
G0514 RN performs assessment Element
G0546 Last 5 days of every 60 days unless: Element
G0582 Influenza and pneumococcal vaccines Element
G0622 Name/contact information of clinical manager Element
G0948 Responsible for all day-to-day operations Element
G0950 Ensure clinical manager is available Element
G1012 Required items in clinical record Element
G1014 Interventions and patient response Element
G1022 Discharge and transfer summaries Element
▼ 147967 Med Plus Home Healthcare, Llc 4440 W Lincoln Hwy, Suite 111 Matteson IL 5 (Chicago) 05/31/2019 IZ5Z11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
E0001 Establishment of the Emergency Program (EP) Condition
E0006 Plan Based on All Hazards Risk Assessment Standard
E0029 Development of Communication Plan Standard
E0036 EP Training and Testing Standard
G0574 Plan of care must include the following Element
G0710 Provide services in the plan of care Element
▼ 147971 Greenpath Health Group, Llc 3232 Sheridan Road Zion IL 5 (Chicago) 06/13/2024 632F9-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
G1024 Authentication Standard
G0434 Participate in care Element
G0580 Only as ordered by a physician Element
G1022 Discharge and transfer summaries Element
▼ 147971 Greenpath Health Group, Llc 3232 Sheridan Road Zion IL 5 (Chicago) 05/04/2018 WFSR11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
▼ 147972 Choice Home Health Services, Inc 5765 N. Lincoln Ave, Ste 21 Chicago IL 5 (Chicago) 02/13/2025 652F8-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0004 Develop EP Plan, Review and Update Annually Standard
E0013 Development of EP Policies and Procedures Standard
E0037 EP Training Program Standard
E0039 EP Testing Requirements Standard
G0372 Encoding and transmitting OASIS Standard
G0572 Plan of care Standard
G0682 Infection Prevention Standard
G1024 Authentication Standard
G0414 HHA administrator contact information Element
G0422 Written notice within 4 business days Element
G0434 Participate in care Element
G0582 Influenza and pneumococcal vaccines Element
G1022 Discharge and transfer summaries Element
▼ 147973 Emmanuel Home Health, Inc 610 Lake Plumleigh Way Algonquin IL 5 (Chicago) 02/14/2025 652FA-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
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
G0372 Encoding and transmitting OASIS Standard
G0572 Plan of care Standard
▼ 147973 Emmanuel Home Health, Inc 610 Lake Plumleigh Way Algonquin IL 5 (Chicago) 12/09/2021 37DD9-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
E0030 Names and Contact Information Standard
G1024 Authentication Standard
G0606 Integrate all services Element