S&C QCOR HHA 2567s
d QCOR:  Quality, Certification and Oversight Reports.
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
148104 Affinity Home Health Services, Inc 7125 W Gunnison Suite-206 Harwood Heights IL 5 (Chicago) 07/29/2021 ZWZU11 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
G0682 Infection Prevention Standard
G1024 Authentication Standard
148104 Affinity Home Health Services, Inc 7125 W Gunnison Suite-206 Harwood Heights IL 5 (Chicago) 07/18/2018 1QZY11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
E0017 HHA Comprehensive Assessment in Disaster Standard
E0023 Policies/Procedures for Medical Documentation Standard
148109 Atrium Home Health Systems, Inc 6600 N Lincoln Ave, Ste 200 Lincolnwood IL 5 (Chicago) 10/25/2024 64499-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
148109 Atrium Home Health Systems, Inc 6600 N Lincoln Ave, Ste 200 Lincolnwood IL 5 (Chicago) 09/23/2021 19654-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0682 Infection Prevention Standard
G1012 Required items in clinical record Element
148113 Good Shepherd Healthcare, Llc 3144 W Montrose Ave, Ste 200 Chicago IL 5 (Chicago) 11/14/2024 64824-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
G0414 HHA administrator contact information Element
G0514 RN performs assessment Element
G0622 Name/contact information of clinical manager Element
148113 Good Shepherd Healthcare, Llc 3144 W Montrose Ave, Ste 200 Chicago IL 5 (Chicago) 09/24/2021 19655-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
148114 Everest Healthcare Solutions 75 Executive Drive Suite 102 Aurora IL 5 (Chicago) 11/20/2024 64828-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
G0422 Written notice within 4 business days Element
148114 Everest Healthcare Solutions 75 Executive Drive Suite 102 Aurora IL 5 (Chicago) 10/01/2021 1964E-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0948 Responsible for all day-to-day operations Element
G1014 Interventions and patient response Element
148122 Great Paragon Healthcare, Inc 2640 W Touhy Ave, Ste 206 Chicago IL 5 (Chicago) 11/27/2024 6482A-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
G0514 RN performs assessment Element
G0550 At discharge Element
G1022 Discharge and transfer summaries Element
148123 Deliverance Home Health Care, Inc 5940 West Touhy Avenue, Ste 205 Niles IL 5 (Chicago) 08/28/2025 1D1E89-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
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
G1022 Discharge and transfer summaries Element