S&C QCOR PRTF 2567s
d QCOR: Quality, Certification and Oversight Reports. S&C QCOR  
Home  |  Help  |  Resources  |  FAQs  |  Site Map  
   
PRTF 2567s
Selection Criteria ▸

Time Interval

Please select the calendar year or years for which you would like data.

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 PRTF 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
▼ 15L011 Columbus Behavioral Center For Children And Adolescents 2223 Poshard Dr Columbus IN 5 (Chicago) 02/13/2024 RFX511 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial comments - not a deficiency citation Memo
N0000 Initial comments - not a deficiency citation Memo
N0143 Orders for use of restraint or seclusion Element
▼ 15L011 Columbus Behavioral Center For Children And Adolescents 2223 Poshard Dr Columbus IN 5 (Chicago) 04/24/2019 R5IN11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial comments - not a deficiency citation Memo
N0000 Initial comments - not a deficiency citation Memo
E0006 Plan based on all hazards risk assessment Standard
E0036 Ep training and testing Standard
N0188 Post intervention debriefings Standard
N0193 Post intervention debriefings Element
▼ 15L013 Gibault Inc Mcgivney West Private Secure 6401 S Us Hwy 41 Terre Haute IN 5 (Chicago) 02/02/2022 UXZA11 Other-Fed, Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial comments - not a deficiency citation Memo
N0000 Initial comments - not a deficiency citation Memo
E0006 Plan based on all hazards risk assessment Standard
E0024 Policies/procedures-volunteers and staffing Standard
E0039 Ep testing requirements Standard
▼ 15L013 Gibault Inc Mcgivney West Private Secure 6401 S Us Hwy 41 Terre Haute IN 5 (Chicago) 10/23/2019 6RDK11 Complaint
Deficiency Tag Deficiency Description Tag Type
N0000 Initial comments - not a deficiency citation Memo
N0115 Individual plan of care Element
N0132 Protection of residents Element
N0145 Orders for use of restraint or seclusion Element
▼ 15L017 Options Treatment Center Acq Corp 5602 Caito Dr Indianapolis IN 5 (Chicago) 02/04/2020 XE7Q11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial comments - not a deficiency citation Memo
N0000 Initial comments - not a deficiency citation Memo
E0039 Ep testing requirements Standard
N0222 Education and training Element
▼ 15L018 Rtc Resource Acq Corp 1404 S State Ave Indianapolis IN 5 (Chicago) 12/18/2023 4EWJ11 Complaint
Deficiency Tag Deficiency Description Tag Type
N0000 Initial comments - not a deficiency citation Memo
N0140 Orders for use of restraint or seclusion Standard
N0188 Post intervention debriefings Standard
N0126 Protection of residents Element
N0128 Protection of residents Element
N0132 Protection of residents Element
N0150 Orders for use of restraint or seclusion Element
N0189 Post intervention debriefings Element
▼ 15L018 Rtc Resource Acq Corp 1404 S State Ave Indianapolis IN 5 (Chicago) 11/29/2022 ABFU11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial comments - not a deficiency citation Memo
N0000 Initial comments - not a deficiency citation Memo
N0143 Orders for use of restraint or seclusion Element
N0197 Medical treatment for injuries Element
▼ 15L018 Rtc Resource Acq Corp 1404 S State Ave Indianapolis IN 5 (Chicago) 04/29/2021 TZ2O11 Complaint
Deficiency Tag Deficiency Description Tag Type
N0000 Initial comments - not a deficiency citation Memo
N0188 Post intervention debriefings Standard
N0145 Orders for use of restraint or seclusion Element
N0189 Post intervention debriefings Element
▼ 15L018 Rtc Resource Acq Corp 1404 S State Ave Indianapolis IN 5 (Chicago) 03/29/2018 K4F211 Complaint
Deficiency Tag Deficiency Description Tag Type
N0000 Initial comments - not a deficiency citation Memo
N0188 Post intervention debriefings Standard
N0115 Individual plan of care Element
▼ 15L018 Rtc Resource Acq Corp 1404 S State Ave Indianapolis IN 5 (Chicago) 02/14/2018 VM6V11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial comments - not a deficiency citation Memo
N0000 Initial comments - not a deficiency citation Memo
E0007 Ep program patient population Standard
E0009 Local, state, tribal collaboration process Standard
E0015 Subsistence needs for staff and patients Standard
E0020 Policies for evac. and primary/alt. comm. Standard
E0025 Arrangement with other facilities Standard
E0030 Names and contact information Standard
E0031 Emergency officials contact information Standard
E0034 Information on occupancy/needs Standard
E0039 Ep testing requirements Standard
N0188 Post intervention debriefings Standard
N0111 Individual plan of care Element
N0115 Individual plan of care Element
N0148 Orders for use of restraint or seclusion Element
N0149 Orders for use of restraint or seclusion Element
N0189 Post intervention debriefings Element