S&C QCOR HHA 2567s
d QCOR:  Quality, Certification and Oversight Reports.
HHAs 2567s
Selection Criteria

Time Interval

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Provider Characteristics

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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
148286 Deluxe Home Health Care, Llc 636 S River Road, Ste 304 Des Plaines IL 5 (Chicago) 09/03/2019 1NZ011 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0372 Encoding and transmitting OASIS Standard
G0950 Ensure clinical manager is available Element
G0954 Ensures qualified pre-designated person Element
148287 Quality Home Health, Llc 17843 Torrence Avenue, Suite 2r Lansing IL 5 (Chicago) 12/07/2023 61A44-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0798 Home health aide assignments and duties Standard
G0514 RN performs assessment Element
G0800 Services provided by HH aide Element
148288 Goodhope Healthcare & Home Health Svcs Inc 3631 Municipal Drive Mchenry IL 5 (Chicago) 02/09/2024 622CB-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0004 Develop EP Plan, Review and Update Annually Standard
E0006 Plan Based on All Hazards Risk Assessment Standard
E0030 Names and Contact Information Standard
E0039 EP Testing Requirements Standard
G0948 Responsible for all day-to-day operations Element
G0950 Ensure clinical manager is available Element
148288 Goodhope Healthcare & Home Health Svcs Inc 3631 Municipal Drive Mchenry IL 5 (Chicago) 03/11/2021 ROMG11 Complaint, 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
G0570 Care planning, coordination, quality of care Condition
E0004 Develop EP Plan, Review and Update Annually Standard
E0036 EP Training and Testing Standard
G0658 Performance improvement projects Standard
G0682 Infection Prevention Standard
G0686 Infection control education Standard
G1024 Authentication Standard
G0454 HHA can no longer meet the patient's needs Element
G0484 Document complaint and resolution Element
G0574 Plan of care must include the following Element
G0580 Only as ordered by a physician Element
G0582 Influenza and pneumococcal vaccines Element
G0584 Verbal orders Element
G0590 Promptly alert relevant physician of changes Element
G0598 Discharge plans communication Element
G0948 Responsible for all day-to-day operations Element
G1014 Interventions and patient response Element
G1022 Discharge and transfer summaries Element
148296 One Home Health Agency, Ltd 390 Congress Parkway, Suite E Crystal Lake IL 5 (Chicago) 11/22/2021 37F18-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0710 Provide services in the plan of care Element
148297 Grace Home Health Care, Inc 625 E 170th St Unit 1ne South Holland IL 5 (Chicago) 03/15/2024 626CA-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0622 Name/contact information of clinical manager Element
148297 Grace Home Health Care, Inc 625 E 170th St Unit 1ne South Holland IL 5 (Chicago) 04/02/2021 3LJL11 Focused Infection Control, Other-Fed, Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0536 A review of all current medications Element
148297 Grace Home Health Care, Inc 625 E 170th St Unit 1ne South Holland IL 5 (Chicago) 02/02/2018 WVM911 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G1024 Authentication Standard
G0706 Interdisciplinary assessment of the patient Element
G0710 Provide services in the plan of care Element
G0808 Onsite supervisory visit every 14 days Element
148298 Angel Home Health Agency Serv Corp 2600 S 25th Ave, Ste 100 Broadview IL 5 (Chicago) 11/16/2023 6172C-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
G0572 Plan of care Standard
G0682 Infection Prevention Standard
G0412 Written notice of patient's rights Element
G0434 Participate in care Element
G0514 RN performs assessment Element
G0582 Influenza and pneumococcal vaccines Element
G0800 Services provided by HH aide Element
G1012 Required items in clinical record Element
G1022 Discharge and transfer summaries Element
148303 Immaculate Home Health, Inc 8340 Lincoln Ave Ste 212 Skokie IL 5 (Chicago) 04/09/2026 22DF3E-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0325 Basis and Scope Condition
G0848 Compliance with Federal, State, Local Law Condition
G0940 Organization and administration of services Condition
G1008 Clinical records Condition
G0850 Disclosure of ownership and management info. Standard
G0860 Licensing Standard
G1024 Authentication Standard
G1026 Retention of records Standard
G0946 Administrator appointed by governing body Element
G0948 Responsible for all day-to-day operations Element
G0952 Ensure that HHA employs qualified personnel Element
G0956 Available during all operating hours Element