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
▼ 148031 Devoted Healthcare, Inc 2720 S River Rd, Ste 4 Des Plaines IL 5 (Chicago) 02/07/2022 38335-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0682 Infection Prevention Standard
G0684 Infection control Standard
G0582 Influenza and pneumococcal vaccines Element
G1022 Discharge and transfer summaries Element
▼ 148034 Optimum Home Health Care, Inc 2720 S River Rd, Ste 202 Des Plaines IL 5 (Chicago) 01/04/2024 61A4D-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0580 Only as ordered by a physician Element
▼ 148034 Optimum Home Health Care, Inc 2720 S River Rd, Ste 202 Des Plaines IL 5 (Chicago) 01/14/2021 2ZQQ11 Focused Infection Control, Other-Fed, Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
E0007 EP Program Patient Population Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0030 Names and Contact Information Standard
G0682 Infection Prevention Standard
G0684 Infection control Standard
G0514 RN performs assessment Element
G0574 Plan of care must include the following Element
G0582 Influenza and pneumococcal vaccines Element
G0602 Communication with all physicians Element
G1022 Discharge and transfer summaries Element
▼ 148035 Community Home Health Care, Inc 109 Fairfield Way, Ste 101 Bloomingdale IL 5 (Chicago) 08/09/2024 63D22-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
E0037 EP Training Program Standard
G0372 Encoding and transmitting OASIS Standard
G0582 Influenza and pneumococcal vaccines Element
G0710 Provide services in the plan of care Element
▼ 148038 Immanuel Home Care Services, Inc 9205 S. Keating, Suite 1 Oaklawn IL 5 (Chicago) 03/07/2024 6266D-H1 Complaint, Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0578 Conformance with physician orders Standard
G0422 Written notice within 4 business days 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
G0590 Promptly alert relevant physician of changes Element
G0622 Name/contact information of clinical manager Element
G1014 Interventions and patient response Element
G1022 Discharge and transfer summaries Element
▼ 148040 Dinamic Health Care, Llc 353 W. Lincoln Hwy Chicago Heights IL 5 (Chicago) 03/15/2024 626C5-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
E0030 Names and Contact Information Standard
E0037 EP Training Program Standard
E0039 EP Testing Requirements Standard
G0578 Conformance with physician orders Standard
G1024 Authentication Standard
G0422 Written notice within 4 business days Element
G0434 Participate in care Element
G0440 Payment from federally funded programs Element
G0514 RN performs assessment Element
G0574 Plan of care must include the following Element
G0728 Rehab services supervised by PT, OT Element
G0808 Onsite supervisory visit every 14 days Element
▼ 148040 Dinamic Health Care, Llc 353 W. Lincoln Hwy Chicago Heights IL 5 (Chicago) 03/25/2021 XQHL11 Focused Infection Control, Other-Fed, Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
E0039 EP Testing Requirements Standard
G0440 Payment from federally funded programs Element
G0582 Influenza and pneumococcal vaccines Element
G0710 Provide services in the plan of care Element
▼ 148041 Hands Of Wellness, Inc 1070 Sibley Boulevard Calumet City IL 5 (Chicago) 03/21/2024 626CC-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
G0578 Conformance with physician orders 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
G0606 Integrate all services Element
G0726 Nursing services supervised by RN Element
G0800 Services provided by HH aide Element
G1012 Required items in clinical record Element
▼ 148041 Hands Of Wellness, Inc 1070 Sibley Boulevard Calumet City IL 5 (Chicago) 04/08/2021 WTOP11 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
G0578 Conformance with physician orders Standard
G0682 Infection Prevention Standard
G0710 Provide services in the plan of care Element
G0800 Services provided by HH aide Element
▼ 148044 Four Season's Home Healthcare, Inc 6050 Oakton Street Morton Grove IL 5 (Chicago) 02/22/2024 623B2-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
E0037 EP Training Program Standard
G0578 Conformance with physician orders Standard
G0414 HHA administrator contact information Element
G0446 Contact info Federal/State-funded entities Element
G0514 RN performs assessment Element
G0582 Influenza and pneumococcal vaccines Element
G0622 Name/contact information of clinical manager Element
G1022 Discharge and transfer summaries Element