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
▼ 148316 Excellent Care Health Services, Inc 400 W Lake Street, Ste 111a Roselle IL 5 (Chicago) 02/23/2018 T64C11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0434 Participate in care Element
▼ 148318 Lkb Health Care, Ltd 3757 W. Touhy Ave. Suite 103 Lincolnwood IL 5 (Chicago) 08/16/2024 63BB0-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
E0039 EP Testing Requirements Standard
G0372 Encoding and transmitting OASIS Standard
G0572 Plan of care Standard
G0682 Infection Prevention Standard
G1024 Authentication Standard
G0582 Influenza and pneumococcal vaccines Element
G0802 Duties of a HH aide Element
G0808 Onsite supervisory visit every 14 days Element
G1022 Discharge and transfer summaries Element
▼ 148318 Lkb Health Care, Ltd 3757 W. Touhy Ave. Suite 103 Lincolnwood IL 5 (Chicago) 07/23/2021 KQ1G11 Focused Infection Control, Other-Fed, Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G1012 Required items in clinical record Element
▼ 148323 Victorious Home Health Agency 21032 80th Avenue Frankfort IL 5 (Chicago) 09/29/2023 60ECE-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
G0572 Plan of care Standard
G1024 Authentication Standard
G0946 Administrator appointed by governing body Element
G0948 Responsible for all day-to-day operations Element
▼ 148323 Victorious Home Health Agency 21032 80th Avenue Frankfort IL 5 (Chicago) 10/30/2020 523T11 Focused Infection Control, Other-Fed, Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0954 Ensures qualified pre-designated person Element
▼ 148324 Precious Nurses Health Care Agency, In 805 West Springfield Avenue Champaign IL 5 (Chicago) 07/10/2019 P6NK11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0940 Organization and administration of services Condition
G0982 Skilled services furnished Standard
▼ 148326 North Shore Healthcare, Inc 1420 Renaissance Drive Park Ridge IL 5 (Chicago) 06/07/2024 63410-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
E0037 EP Training Program Standard
G0372 Encoding and transmitting OASIS Standard
G1024 Authentication Standard
G0580 Only as ordered by a physician Element
G1022 Discharge and transfer summaries Element
▼ 148326 North Shore Healthcare, Inc 1420 Renaissance Drive Park Ridge IL 5 (Chicago) 06/10/2021 FOWW11 Focused Infection Control, Other-Fed, Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0578 Conformance with physician orders Standard
▼ 148326 North Shore Healthcare, Inc 1420 Renaissance Drive Park Ridge IL 5 (Chicago) 08/07/2019 JCCL11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0710 Provide services in the plan of care Element
G0948 Responsible for all day-to-day operations Element
▼ 148326 North Shore Healthcare, Inc 1420 Renaissance Drive Park Ridge IL 5 (Chicago) 05/17/2018 1R5O11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
E0017 HHA Comprehensive Assessment in Disaster Standard
G1024 Authentication Standard
G0574 Plan of care must include the following Element
G0580 Only as ordered by a physician Element
G1012 Required items in clinical record Element