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
▼ 148235 Excell Home Health Services, Inc 195 N Harbor Dr, Ste 4909 Chicago IL 5 (Chicago) 01/15/2026 1D82E0-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
G0984 In accordance with current clinical practice Element
G1012 Required items in clinical record Element
G1014 Interventions and patient response Element
G1022 Discharge and transfer summaries Element
▼ 148235 Excell Home Health Services, Inc 195 N Harbor Dr, Ste 4909 Chicago IL 5 (Chicago) 10/20/2022 4F7CF-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0514 RN performs assessment Element
G0582 Influenza and pneumococcal vaccines Element
G0710 Provide services in the plan of care Element
▼ 148235 Excell Home Health Services, Inc 195 N Harbor Dr, Ste 4909 Chicago IL 5 (Chicago) 12/18/2019 K8LL11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0440 Payment from federally funded programs Element
G0710 Provide services in the plan of care Element
G1014 Interventions and patient response Element
▼ 148236 Dominion Home Health Care, Inc 3434 Ridge Road Lansing IL 5 (Chicago) 11/17/2022 5E27A-H1 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
G0687 COVID-19 Vaccination of Home Health Agency staff Standard
G1024 Authentication Standard
G0514 RN performs assessment Element
G0574 Plan of care must include the following Element
G0948 Responsible for all day-to-day operations Element
▼ 148237 Epic Home Care, Inc 710 E Ogden Ave Suite 690 Naperville IL 5 (Chicago) 04/02/2026 1F1F21-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
G0434 Participate in care Element
G0582 Influenza and pneumococcal vaccines Element
G0808 Onsite supervisory visit every 14 days Element
G1022 Discharge and transfer summaries Element
▼ 148237 Epic Home Care, Inc 710 E Ogden Ave Suite 690 Naperville IL 5 (Chicago) 12/22/2022 5E5A7-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0006 Plan Based on All Hazards Risk Assessment Standard
G0572 Plan of care Standard
G0706 Interdisciplinary assessment of the patient Element
▼ 148237 Epic Home Care, Inc 710 E Ogden Ave Suite 690 Naperville IL 5 (Chicago) 02/21/2020 SSLF11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0710 Provide services in the plan of care Element
G0808 Onsite supervisory visit every 14 days Element
G1012 Required items in clinical record Element
▼ 148238 Distinct Home Health Care, Llc 1328 Main Street Crete IL 5 (Chicago) 09/11/2025 1D5795-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
G0422 Written notice within 4 business days Element
G0434 Participate in care Element
G0574 Plan of care must include the following Element
G0582 Influenza and pneumococcal vaccines Element
G0608 Coordinate care delivery Element
G0622 Name/contact information of clinical manager Element
G0808 Onsite supervisory visit every 14 days Element
G1014 Interventions and patient response Element
▼ 148238 Distinct Home Health Care, Llc 1328 Main Street Crete IL 5 (Chicago) 09/06/2019 WWTC11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0550 At discharge Element
G0574 Plan of care must include the following Element
G1012 Required items in clinical record Element
▼ 148240 Healthy Health Home Health, Inc 4747 Lincoln Mall Drive, Suite 260 Matteson IL 5 (Chicago) 04/09/2026 22C3C4-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0422 Written notice within 4 business days Element
G0444 State toll free HH telephone hotline Element
G0574 Plan of care must include the following Element
G1022 Discharge and transfer summaries Element