S&C QCOR PRTF 2567s
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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
▼ 16L030 Rosecrance Jackson Centers 3500 West 4th Street Sioux City IA 7 (Kansas City) 02/03/2026 WZL011 Complaint
Deficiency Tag Deficiency Description Tag Type
N0000 Initial comments - not a deficiency citation Memo
N0140 Orders for use of restraint or seclusion Standard
N0145 Orders for use of restraint or seclusion Element
N0148 Orders for use of restraint or seclusion Element
N0189 Post intervention debriefings Element
N0193 Post intervention debriefings Element
N0222 Education and training Element
▼ 16L034 Four Oaks Family & Children's Services Of Iowa - North Oaks-Pmic 5400 Kirwood Blvd Sw Cedar Rapids IA 7 (Kansas City) 09/14/2022 9VRQ11 Initial Certification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial comments - not a deficiency citation Memo
E0006 Plan based on all hazards risk assessment Standard
E0009 Local, state, tribal collaboration process Standard
E0039 Ep testing requirements Standard
N0101 General requirement for prtf Standard
N0120 Covid-19 vaccination of facility staff Standard
N0140 Orders for use of restraint or seclusion Standard
N0136 Protection of residents Element
N0137 Protection of residents Element
N0145 Orders for use of restraint or seclusion Element
N0222 Education and training Element
▼ 16L035 Four Oaks Family & Children's Services Of Iowa - Berkeley Unit 80 N Eisenhower Mason City IA 7 (Kansas City) 05/02/2024 ZNJK11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial comments - not a deficiency citation Memo
N0000 Initial comments - not a deficiency citation Memo
N0137 Protection of residents Element
N0156 Orders for use of restraint or seclusion Element
N0202 Medical treatment for injuries Element
▼ 16L036 Four Oaks Family & Children's Services Of Iowa - Cambridge Unit 80 N, Eisenhower Mason City IA 7 (Kansas City) 12/29/2025 WZET11 Complaint
Deficiency Tag Deficiency Description Tag Type
N0000 Initial comments - not a deficiency citation Memo
N0188 Post intervention debriefings Standard
N0189 Post intervention debriefings Element
▼ 16L038 Orchard Place Shiffer House 925 Sw Porter Des Moines IA 7 (Kansas City) 12/04/2025 FZX711 Complaint
Deficiency Tag Deficiency Description Tag Type
N0000 Initial comments - not a deficiency citation Memo
N0170 Monitoring during and after seclusion Standard
▼ 16L038 Orchard Place Shiffer House 925 Sw Porter Des Moines IA 7 (Kansas City) 05/05/2023 8ODC11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial comments - not a deficiency citation Memo
E0007 Ep program patient population Standard
E0024 Policies/procedures-volunteers and staffing Standard
N0189 Post intervention debriefings Element
N0218 Education and training Element
N0222 Education and training Element
▼ 16L038 Orchard Place Shiffer House 925 Sw Porter Des Moines IA 7 (Kansas City) 09/24/2018 2EBC11 Initial Certification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial comments - not a deficiency citation Memo
N0000 Initial comments - not a deficiency citation Memo
N0188 Post intervention debriefings Standard
N0145 Orders for use of restraint or seclusion Element
N0148 Orders for use of restraint or seclusion Element
N0189 Post intervention debriefings Element
N0222 Education and training Element
▼ 16L039 Christian Home Assoc Children's Square Usa - Nelson Family - Cottage 3 619 Curtis Street Co Bluffs IA 7 (Kansas City) 03/30/2026 N5TT11 Initial Certification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial comments - not a deficiency citation Memo
N0000 Initial comments - not a deficiency citation Memo
N0188 Post intervention debriefings Standard
N0144 Orders for use of restraint or seclusion Element
N0145 Orders for use of restraint or seclusion Element
N0222 Education and training Element
▼ 16L099 Boys & Girls Home & Family Serv Inc-Brick 1551 Indian Hills Suite 1 Sioux City IA 7 (Kansas City) 12/31/2025 CSCE11 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
▼ 16L099 Boys & Girls Home & Family Serv Inc-Brick 1551 Indian Hills Suite 1 Sioux City IA 7 (Kansas City) 11/20/2025 1BLC11 Complaint
Deficiency Tag Deficiency Description Tag Type
N0170 Monitoring during and after seclusion Standard
N0188 Post intervention debriefings Standard