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
▼ 148018 Vintage Healthcare Services 20300 Governors Highway Olympia Fields IL 5 (Chicago) 11/23/2021 37FDE-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G1012 Required items in clinical record Element
▼ 148021 Maxicare Home Health Services 6201 W Howard Street Suite 206 Niles IL 5 (Chicago) 12/15/2023 61A4B-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
▼ 148021 Maxicare Home Health Services 6201 W Howard Street Suite 206 Niles IL 5 (Chicago) 01/07/2021 QP1J11 Focused Infection Control, Other-Fed, Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0590 Promptly alert relevant physician of changes Element
G1012 Required items in clinical record Element
▼ 148023 Faith Home Healthcare, Inc 8224 S. Kedzie Ave, 2nd Floor Rear Chicago IL 5 (Chicago) 10/05/2023 61270-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G1024 Authentication Standard
G0434 Participate in care Element
G0444 State toll free HH telephone hotline Element
G0574 Plan of care must include the following Element
G0580 Only as ordered by a physician Element
G1012 Required items in clinical record Element
▼ 148025 Premier Point Home Health, Inc 4701 N Sheridan Road Chicago IL 5 (Chicago) 08/15/2024 63BAE-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
E0029 Development of Communication Plan Standard
E0039 EP Testing Requirements Standard
G0372 Encoding and transmitting OASIS Standard
G0808 Onsite supervisory visit every 14 days Element
G1022 Discharge and transfer summaries Element
▼ 148025 Premier Point Home Health, Inc 4701 N Sheridan Road Chicago IL 5 (Chicago) 07/22/2021 D2YY11 Focused Infection Control, Other-Fed, Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0682 Infection Prevention Standard
G0582 Influenza and pneumococcal vaccines Element
G0972 Report all branch locations to SA Element
▼ 148025 Premier Point Home Health, Inc 4701 N Sheridan Road Chicago IL 5 (Chicago) 06/29/2018 GXR411 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
G1018 Contact information for the patient Element
▼ 148027 Wellspring Healthcare Services, Inc 3590 Hobson Road, Ste 404 Woodridge IL 5 (Chicago) 11/30/2023 61730-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
E0037 EP Training Program Standard
G0684 Infection control Standard
G0412 Written notice of patient's rights Element
G0434 Participate in care Element
G0514 RN performs assessment Element
G0574 Plan of care must include the following Element
G0582 Influenza and pneumococcal vaccines Element
G1014 Interventions and patient response Element
▼ 148029 Diversified Home Care, Inc 5501 West Montrose Avenue, Unit D Chicago IL 5 (Chicago) 05/21/2026 230A15-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
▼ 148031 Devoted Healthcare, Inc 2720 S River Rd, Ste 4 Des Plaines IL 5 (Chicago) 04/10/2025 65BA0-H1 Complaint, 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
E0037 EP Training Program Standard
G0372 Encoding and transmitting OASIS Standard
G0572 Plan of care Standard
G0414 HHA administrator contact information Element
G0422 Written notice within 4 business days Element
G0434 Participate in care Element
G0464 Advise the patient of discharge for cause Element
G0468 Provide contact info other services Element
G0470 Document efforts to resolve problems Element
G0574 Plan of care must include the following Element
G0582 Influenza and pneumococcal vaccines Element
G0622 Name/contact information of clinical manager Element
G1012 Required items in clinical record Element
G1022 Discharge and transfer summaries Element