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
148123 Deliverance Home Health Care, Inc 5940 West Touhy Avenue, Ste 205 Niles IL 5 (Chicago) 08/16/2019 Z1MB11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0808 Onsite supervisory visit every 14 days Element
G1012 Required items in clinical record Element
148124 Alphazeta Healthcare Services, Llc 5901 N Cicero Ave, Ste 105 Chicago IL 5 (Chicago) 02/26/2025 652FC-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
G0372 Encoding and transmitting OASIS Standard
G1022 Discharge and transfer summaries Element
148124 Alphazeta Healthcare Services, Llc 5901 N Cicero Ave, Ste 105 Chicago IL 5 (Chicago) 12/09/2021 37F5A-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
E0030 Names and Contact Information Standard
G0682 Infection Prevention Standard
G0514 RN performs assessment Element
G0582 Influenza and pneumococcal vaccines Element
G1014 Interventions and patient response Element
148124 Alphazeta Healthcare Services, Llc 5901 N Cicero Ave, Ste 105 Chicago IL 5 (Chicago) 12/28/2018 YK1E11 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
G0808 Onsite supervisory visit every 14 days Element
148126 Cimpar At Home Llc 101 Madison St, Ste 300 Oak Park IL 5 (Chicago) 11/08/2024 64497-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
G0372 Encoding and transmitting OASIS Standard
G0850 Disclosure of ownership and management info. Standard
G0574 Plan of care must include the following Element
G0622 Name/contact information of clinical manager Element
148128 Sacred Heart Home Health, Inc 2720 S River Road Suite 144 Des Plaines IL 5 (Chicago) 05/09/2025 660C6-H1 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
E0039 EP Testing Requirements Standard
G0372 Encoding and transmitting OASIS Standard
G0798 Home health aide assignments and duties Standard
G0414 HHA administrator contact information 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
G0606 Integrate all services Element
G0622 Name/contact information of clinical manager Element
G0808 Onsite supervisory visit every 14 days Element
148129 Aim Home Health, Inc 3033 Ogden Avenue Suite 211 Lisle IL 5 (Chicago) 06/20/2025 66485-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G1022 Discharge and transfer summaries Element
148129 Aim Home Health, Inc 3033 Ogden Avenue Suite 211 Lisle IL 5 (Chicago) 03/17/2022 38678-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
E0030 Names and Contact Information Standard
G0687 COVID-19 Vaccination of Home Health Agency staff Standard
G1024 Authentication Standard
G0440 Payment from federally funded programs Element
148131 Guardian Home Health Services, Inc 7370 North Lincoln Avenue Suite C Lincolnwood IL 5 (Chicago) 10/04/2024 64492-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
148131 Guardian Home Health Services, Inc 7370 North Lincoln Avenue Suite C Lincolnwood IL 5 (Chicago) 09/03/2021 WH5L11 Focused Infection Control, Other-Fed, Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0434 Participate in care Element
G0582 Influenza and pneumococcal vaccines Element
G0948 Responsible for all day-to-day operations Element
G1012 Required items in clinical record Element