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
▼ 147992 Agape Home Health Care, Inc 19900 Governors Dr, Ste Ll 10 Olympia Fields IL 5 (Chicago) 01/02/2020 QIMK11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0586 Review and revision of the plan of care Standard
G1024 Authentication Standard
G1012 Required items in clinical record Element
▼ 147999 Home Health One, Ltd 825 N Cass Ave, Ste 111 Westmont IL 5 (Chicago) 06/23/2025 6675D-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0710 Provide services in the plan of care Element
▼ 148001 Hope Home Health Services, Inc 121 S Wilke Rd, Ste 410 Arlington Heights IL 5 (Chicago) 01/25/2024 61F16-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
G0452 Transfer and discharge Standard
G0578 Conformance with physician orders Standard
G0414 HHA administrator contact information Element
G0446 Contact info Federal/State-funded entities Element
G0550 At discharge Element
G0574 Plan of care must include the following Element
G0580 Only as ordered by a physician Element
G0622 Name/contact information of clinical manager Element
G1018 Contact information for the patient Element
G1022 Discharge and transfer summaries Element
▼ 148002 Tru-Care Home Health, Inc 7341 W Talcott Ave Chicago IL 5 (Chicago) 12/04/2025 1D57A6-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
G0850 Disclosure of ownership and management info. Standard
G1024 Authentication Standard
G0574 Plan of care must include the following Element
G0582 Influenza and pneumococcal vaccines Element
G1022 Discharge and transfer summaries Element
▼ 148002 Tru-Care Home Health, Inc 7341 W Talcott Ave Chicago IL 5 (Chicago) 09/13/2019 QELS11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0710 Provide services in the plan of care Element
G0808 Onsite supervisory visit every 14 days Element
▼ 148004 Adoration Home Health Of Illinois, Llc 1901 Franks Scott Parkway, Suite 4 O Fallon IL 5 (Chicago) 03/21/2024 624BB-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0039 EP Testing Requirements Standard
G0578 Conformance with physician orders Standard
G0536 A review of all current medications Element
▼ 148004 Adoration Home Health Of Illinois, Llc 1901 Franks Scott Parkway, Suite 4 O Fallon IL 5 (Chicago) 03/18/2021 JH4N11 Focused Infection Control, Other-Fed, Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0578 Conformance with physician orders Standard
G0654 Track adverse patient events Standard
G0536 A review of all current medications Element
G0590 Promptly alert relevant physician of changes Element
▼ 148007 At Homehealth, Inc 3344 W Peterson Ave, Ste 104 Chicago IL 5 (Chicago) 08/10/2023 60AA5-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0582 Influenza and pneumococcal vaccines Element
▼ 148012 Accelerated Home Care, Llc 830 E Higgins Road Suite 101 Schaumburg IL 5 (Chicago) 07/13/2023 60457-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
E0030 Names and Contact Information Standard
G0518 Completion of the comprehensive assessment Standard
G0572 Plan of care Standard
G0578 Conformance with physician orders Standard
G0514 RN performs assessment Element
G1014 Interventions and patient response Element
G1022 Discharge and transfer summaries Element
▼ 148018 Vintage Healthcare Services 20300 Governors Highway Olympia Fields IL 5 (Chicago) 12/28/2023 61A4F-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0001 Establishment of the Emergency Program (EP) Condition
G0940 Organization and administration of services Condition
E0004 Develop EP Plan, Review and Update Annually Standard
E0006 Plan Based on All Hazards Risk Assessment Standard
E0029 Development of Communication Plan Standard
E0036 EP Training and Testing Standard
G0572 Plan of care Standard
G0578 Conformance with physician orders Standard
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0582 Influenza and pneumococcal vaccines Element
G0800 Services provided by HH aide Element
G0808 Onsite supervisory visit every 14 days Element
G0948 Responsible for all day-to-day operations Element
G0950 Ensure clinical manager is available Element
G0954 Ensures qualified pre-designated person Element
G1012 Required items in clinical record Element
G1022 Discharge and transfer summaries Element