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
▼ 148149 Medcare Home Health, Inc 3924 West Devon Avenue, Suite D Lincolnwood IL 5 (Chicago) 02/08/2019 IT1211 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
E0030 Names and Contact Information Standard
E0037 EP Training Program Standard
G0852 Information to the state survey agency Standard
G0574 Plan of care must include the following Element
G0710 Provide services in the plan of care Element
G0808 Onsite supervisory visit every 14 days Element
G1012 Required items in clinical record Element
▼ 148151 Gl Healthcare, Inc 402 W Bougton Rd, Ste B Bolingbrook IL 5 (Chicago) 01/10/2025 64F7F-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0030 Names and Contact Information Standard
E0039 EP Testing Requirements Standard
G0372 Encoding and transmitting OASIS Standard
G0572 Plan of care Standard
G0574 Plan of care must include the following Element
▼ 148151 Gl Healthcare, Inc 402 W Bougton Rd, Ste B Bolingbrook IL 5 (Chicago) 10/28/2021 37D55-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0039 EP Testing Requirements Standard
G0440 Payment from federally funded programs Element
G1012 Required items in clinical record Element
G1022 Discharge and transfer summaries Element
▼ 148154 Vitacare Health Services, Inc 4736 S Main Street, Ste 8 Lisle IL 5 (Chicago) 05/15/2025 660C9-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
G0574 Plan of care must include the following Element
G1014 Interventions and patient response Element
▼ 148154 Vitacare Health Services, Inc 4736 S Main Street, Ste 8 Lisle IL 5 (Chicago) 02/18/2022 3833E-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0578 Conformance with physician orders Standard
G1024 Authentication Standard
▼ 148154 Vitacare Health Services, Inc 4736 S Main Street, Ste 8 Lisle IL 5 (Chicago) 03/08/2019 0SEN11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0710 Provide services in the plan of care Element
▼ 148156 Patient Plus Homehealth Care, Inc 2521 Ridge Road Suite 3 Lansing IL 5 (Chicago) 05/22/2025 660CB-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
G0434 Participate in care Element
G0514 RN performs assessment Element
G0580 Only as ordered by a physician Element
G0582 Influenza and pneumococcal vaccines Element
G0622 Name/contact information of clinical manager Element
G1022 Discharge and transfer summaries Element
▼ 148156 Patient Plus Homehealth Care, Inc 2521 Ridge Road Suite 3 Lansing IL 5 (Chicago) 02/25/2022 38341-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0452 Transfer and discharge Standard
G1024 Authentication Standard
G0440 Payment from federally funded programs Element
▼ 148156 Patient Plus Homehealth Care, Inc 2521 Ridge Road Suite 3 Lansing IL 5 (Chicago) 03/22/2019 GO6R11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0574 Plan of care must include the following Element
G0710 Provide services in the plan of care Element
▼ 148157 Total Health Home Care Services, Inc 19150 S Kedzie Ave, Suite 202 Flossmoor IL 5 (Chicago) 03/28/2025 657E0-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