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
148276 Angel's Care Home Health Services, Inc 5418 N Kedzie Avenue Chicago IL 5 (Chicago) 02/06/2020 D6OO11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
E0017 HHA Comprehensive Assessment in Disaster Standard
G0512 Standard: Initial assessment visit. Standard
G0774 12 hours inservice every 12 months Standard
G0588 Reviewed, revised by physician every 60 days Element
G0954 Ensures qualified pre-designated person Element
G1022 Discharge and transfer summaries Element
148286 Deluxe Home Health Care, Llc 636 S River Road, Ste 304 Des Plaines IL 5 (Chicago) 10/20/2023 61288-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0578 Conformance with physician orders Standard
148286 Deluxe Home Health Care, Llc 636 S River Road, Ste 304 Des Plaines IL 5 (Chicago) 11/20/2020 7LLE11 Focused Infection Control, Other-Fed, Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0852 Information to the state survey agency Standard
G0946 Administrator appointed by governing body Element
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