S&C QCOR HHA 2567s
d QCOR:  Quality, Certification and Oversight Reports.
HHAs 2567s
Selection Criteria

Time Interval

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Provider Characteristics

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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
148054 Heaven's Angels Health Care Services Inc 7366 N Lincoln Ave, Ste 202 Lincolnwood IL 5 (Chicago) 11/20/2024 64829-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
148056 Open Waters Home Health Care, Inc 5940 West Touhy Avenue Suite 145 Niles IL 5 (Chicago) 11/15/2023 6183E-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0582 Influenza and pneumococcal vaccines Element
148056 Open Waters Home Health Care, Inc 5940 West Touhy Avenue Suite 145 Niles IL 5 (Chicago) 12/31/2020 DUIQ11 Focused Infection Control, Other-Fed, Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0682 Infection Prevention Standard
G1024 Authentication Standard
G0514 RN performs assessment Element
G0580 Only as ordered by a physician Element
148060 New Haven Home Health Care, Inc 10700 West Higgins Road Rosemont IL 5 (Chicago) 01/19/2024 61EE3-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0514 RN performs assessment Element
G0580 Only as ordered by a physician Element
G0706 Interdisciplinary assessment of the patient Element
G1022 Discharge and transfer summaries Element
148060 New Haven Home Health Care, Inc 10700 West Higgins Road Rosemont IL 5 (Chicago) 02/19/2021 YSLQ11 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
E0030 Names and Contact Information Standard
G1012 Required items in clinical record Element
148067 Samaritan Healthcare, Llc 1585 Ellinwood Avenue #L-19 Des Plaines IL 5 (Chicago) 06/29/2018 BCJI12 Recertification
Deficiency Tag Deficiency Description Tag Type
E0001 Establishment of the Emergency Program (EP) Condition
E0004 Develop EP Plan, Review and Update Annually Standard
E0029 Development of Communication Plan Standard
E0036 EP Training and Testing Standard
G0958 Clinical manager Standard
G0444 State toll free HH telephone hotline Element
G0580 Only as ordered by a physician Element
G0710 Provide services in the plan of care Element
G0714 Patient and caregiver education Element
148068 Abundant Home Health Care, Inc 545 W Taft Ave South Holland IL 5 (Chicago) 05/02/2024 62CB3-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0622 Name/contact information of clinical manager Element
G0956 Available during all operating hours Element
148068 Abundant Home Health Care, Inc 545 W Taft Ave South Holland IL 5 (Chicago) 05/06/2021 519W11 Focused Infection Control, Other-Fed, Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G1024 Authentication Standard
G0514 RN performs assessment Element
G0710 Provide services in the plan of care Element
G0726 Nursing services supervised by RN Element
G1012 Required items in clinical record Element
G1014 Interventions and patient response Element
148068 Abundant Home Health Care, Inc 545 W Taft Ave South Holland IL 5 (Chicago) 06/07/2018 GXJ711 Recertification, Sample Validation
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
E0001 Establishment of the Emergency Program (EP) Condition
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0036 EP Training and Testing Standard
G0644 Program data Standard
G0606 Integrate all services Element
G0726 Nursing services supervised by RN Element
148071 Advance Home Health Care Provider Corp 935 West 175th Street, Suite 102 Homewood IL 5 (Chicago) 02/08/2024 622A5-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0578 Conformance with physician orders Standard
G0434 Participate in care Element
G0582 Influenza and pneumococcal vaccines Element