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
▼ 148071 Advance Home Health Care Provider Corp 935 West 175th Street, Suite 102 Homewood IL 5 (Chicago) 01/05/2018 Z9ZI11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0121 COMPLIANCE W/ ACCEPTED PROFESSIONAL STD Standard
G0145 COORDINATION OF PATIENT SERVICES Standard
G0158 ACCEPTANCE OF PATIENTS, POC, MED SUPER Standard
G0159 PLAN OF CARE Standard
G0229 SUPERVISION Standard
G0236 CLINICAL RECORDS Standard
G0332 INITIAL ASSESSMENT VISIT Standard
G0341 UPDATE OF THE COMPREHENSIVE ASSESSMENT Standard
▼ 148073 Crystal Home Health Care, Llc 2720 S River Road, Suite 154 Des Plaines IL 5 (Chicago) 11/14/2024 64825-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
G0572 Plan of care Standard
G1024 Authentication Standard
G0580 Only as ordered by a physician Element
G0582 Influenza and pneumococcal vaccines Element
▼ 148076 Nett Hands Home Care, Inc 16643 South Kedzie Avenue, Suite 101 Markham IL 5 (Chicago) 09/20/2024 63FF5-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
G0682 Infection Prevention Standard
G0710 Provide services in the plan of care Element
G0952 Ensure that HHA employs qualified personnel Element
▼ 148076 Nett Hands Home Care, Inc 16643 South Kedzie Avenue, Suite 101 Markham IL 5 (Chicago) 08/12/2021 UZVW11 Focused Infection Control, Other-Fed, Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
E0001 Establishment of the Emergency Program (EP) Condition
E0030 Names and Contact Information Standard
E0036 EP Training and Testing Standard
G0572 Plan of care Standard
G0682 Infection Prevention Standard
G0434 Participate in care Element
G0514 RN performs assessment Element
G0582 Influenza and pneumococcal vaccines Element
G1022 Discharge and transfer summaries Element
▼ 148077 Midwest Healthcare Provider, Inc 5360 Fargo Ave Skokie IL 5 (Chicago) 08/30/2024 63BB5-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
G0572 Plan of care Standard
G1024 Authentication Standard
▼ 148077 Midwest Healthcare Provider, Inc 5360 Fargo Ave Skokie IL 5 (Chicago) 07/30/2021 Y4JD11 Focused Infection Control, Other-Fed, Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0706 Interdisciplinary assessment of the patient Element
G0710 Provide services in the plan of care Element
▼ 148078 Apollo Home Care, Inc 3030 Finley Road Suite 140 Downers Grove IL 5 (Chicago) 07/26/2024 63732-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
G0514 RN performs assessment Element
G0808 Onsite supervisory visit every 14 days Element
▼ 148078 Apollo Home Care, Inc 3030 Finley Road Suite 140 Downers Grove IL 5 (Chicago) 05/23/2018 GUL211 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0768 Competency evaluation Standard
G0798 Home health aide assignments and duties Standard
▼ 148079 Covenant Home Health Care, Inc 9547 Crawford Avenue Evanston IL 5 (Chicago) 08/02/2024 63736-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
E0039 EP Testing Requirements Standard
G0372 Encoding and transmitting OASIS Standard
G0622 Name/contact information of clinical manager Element
▼ 148079 Covenant Home Health Care, Inc 9547 Crawford Avenue Evanston IL 5 (Chicago) 07/09/2021 ZT7R11 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
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0030 Names and Contact Information Standard