S&C QCOR HHA 2567s
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HHAs 2567s
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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
▼ 157555 A Plus Home Health Care Incorporated 2246-A Industrial Dr Highland IN 5 (Chicago) 03/17/2025 65875-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0682 Infection Prevention Standard
G0576 All orders recorded in plan of care Element
G0580 Only as ordered by a physician Element
G1022 Discharge and transfer summaries Element
▼ 157555 A Plus Home Health Care Incorporated 2246-A Industrial Dr Highland IN 5 (Chicago) 03/17/2022 386DF-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0578 Conformance with physician orders Standard
G0528 Health, psychosocial, functional, cognition Element
G0574 Plan of care must include the following Element
▼ 157555 A Plus Home Health Care Incorporated 2246-A Industrial Dr Highland IN 5 (Chicago) 05/06/2021 1K6Z11 Complaint, Focused Infection Control, Other-Fed
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0544 Update of the comprehensive assessment Standard
G0572 Plan of care Standard
G0682 Infection Prevention Standard
G0798 Home health aide assignments and duties Standard
G1024 Authentication Standard
G0534 Patient's needs Element
G0574 Plan of care must include the following Element
G0576 All orders recorded in plan of care Element
G0590 Promptly alert relevant physician of changes Element
G0614 Visit schedule Element
G0616 Patient medication schedule/instructions Element
G0804 Aides are members of interdisciplinary team Element
G0808 Onsite supervisory visit every 14 days Element
▼ 157557 Adarna Home Health Care Services Inc 1400 East Joliet Street Crown Point IN 5 (Chicago) 07/24/2018 PIRS11 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
G0682 Infection Prevention Standard
G1024 Authentication Standard
G0514 RN performs assessment Element
G0948 Responsible for all day-to-day operations Element
G1022 Discharge and transfer summaries Element
▼ 157558 Aesquivel Professional Corporation 9721 Prairie Avenue Highland IN 5 (Chicago) 07/11/2025 65B51-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0520 5 calendar days after start of care Element
G0528 Health, psychosocial, functional, cognition Element
G0574 Plan of care must include the following Element
▼ 157558 Aesquivel Professional Corporation 9721 Prairie Avenue Highland IN 5 (Chicago) 07/19/2022 4F042-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
E0017 HHA Comprehensive Assessment in Disaster Standard
E0019 Homebound HHA/Hospice Inform EP Officials Standard
E0030 Names and Contact Information Standard
E0037 EP Training Program Standard
E0039 EP Testing Requirements Standard
G0526 Content of the comprehensive assessment Standard
G0564 Discharge or Transfer Summary Content Standard
G0572 Plan of care Standard
G0536 A review of all current medications Element
G0538 Primary caregiver(s), if any Element
G0574 Plan of care must include the following Element
G0576 All orders recorded in plan of care Element
G0608 Coordinate care delivery Element
G0616 Patient medication schedule/instructions Element
G0618 Treatments and therapy services Element
G0716 Preparing clinical notes Element
G0718 Communication with physicians Element
G0808 Onsite supervisory visit every 14 days Element
▼ 157558 Aesquivel Professional Corporation 9721 Prairie Avenue Highland IN 5 (Chicago) 09/09/2019 JPIV11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0682 Infection Prevention Standard
G0534 Patient's needs Element
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0590 Promptly alert relevant physician of changes Element
G0710 Provide services in the plan of care Element
G0716 Preparing clinical notes Element
G0800 Services provided by HH aide Element
▼ 157560 Neighborhood Home Health Services Llc 5701 Elmwood Ave Ste N Indianapolis IN 5 (Chicago) 03/12/2025 65923-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0514 RN performs assessment Element
G0576 All orders recorded in plan of care Element
G0580 Only as ordered by a physician Element
G0590 Promptly alert relevant physician of changes Element
G0598 Discharge plans communication Element
▼ 157560 Neighborhood Home Health Services Llc 5701 Elmwood Ave Ste N Indianapolis IN 5 (Chicago) 07/08/2019 EK0511 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0434 Participate in care Element
G0550 At discharge Element
G0574 Plan of care must include the following Element
G0582 Influenza and pneumococcal vaccines Element
G0584 Verbal orders Element
G0588 Reviewed, revised by physician every 60 days Element
G0716 Preparing clinical notes Element
▼ 157561 Anrex Home Care Inc 3449 Ridge Road Ste 1 Highland IN 5 (Chicago) 01/23/2020 T62N11 Recertification, Sample Validation
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0001 Establishment of the Emergency Program (EP) Condition
G0570 Care planning, coordination, quality of care Condition
G0640 Quality assessment/performance improvement Condition
E0009 Local, State, Tribal Collaboration Process Standard
E0017 HHA Comprehensive Assessment in Disaster Standard
E0019 Homebound HHA/Hospice Inform EP Officials Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0030 Names and Contact Information Standard
E0031 Emergency Officials Contact Information Standard
G0572 Plan of care Standard
G0644 Program data Standard
G0658 Performance improvement projects Standard
G1024 Authentication Standard
G1028 Protection of records Standard
G0412 Written notice of patient's rights Element
G0434 Participate in care Element
G0444 State toll free HH telephone hotline Element
G0528 Health, psychosocial, functional, cognition Element
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0584 Verbal orders Element
G0590 Promptly alert relevant physician of changes Element
G0592 Revised plan of care Element
G0596 Revisions communicated to patient and MDs Element
G0606 Integrate all services Element
G0614 Visit schedule Element
G0648 High risk, high volume, or problem-prone area Element
G0718 Communication with physicians Element
G0818 HH aide supervision elements Element
G0960 Make patient and personnel assignments, Element
G0978 Must have a written agreement Element