S&C QCOR RHC 2567s
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RHCs 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 RHC 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
▼ 288519 Humphrey Medical Clinic 303 Main Street Humphrey NE 7 (Kansas City) 10/25/2019 FPW511 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0160 Program Evaluation Condition
J0123 Staffing And Staff Responsibilities Standard
J0161 Program Evaluation Standard
J0162 Program Evaluation Standard
▼ 288521 Avera Medical Group Laflan 804 Chase Avenue Creighton NE 7 (Kansas City) 08/06/2019 YKRI11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0086 Staffing And Staff Responsibilities Standard
J0136 Provision Of Services Standard
J0161 Program Evaluation Standard
▼ 288530 Fullerton Medical Clinic 901 Broadway Street Fullerton NE 7 (Kansas City) 02/20/2024 S75711 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
J0123 Staffing And Staff Responsibilities Standard
▼ 288530 Fullerton Medical Clinic 901 Broadway Street Fullerton NE 7 (Kansas City) 03/16/2020 7H2112 Standard
Deficiency Tag Deficiency Description Tag Type
J0000 Initial Comments - Not A Deficiency Citation Memo
J0072 Protection of Record Information Standard
▼ 288531 Central City Medical Clinic 2802 28th St, Suite 100 Central City NE 7 (Kansas City) 02/20/2024 YXU711 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
J0123 Staffing And Staff Responsibilities Standard
▼ 288533 Randolph Family Practice Clinic 106 E Wayne Street Randolph NE 7 (Kansas City) 06/13/2018 THYQ11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0083 Staffing And Staff Responsibilities Standard
▼ 288534 Wausa Medical Clinic 100 N Lincoln Street Wausa NE 7 (Kansas City) 06/12/2018 K46911 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0083 Staffing And Staff Responsibilities Standard
▼ 288547 Park Street Medical Clinic 505 South Park Street Genoa NE 7 (Kansas City) 03/25/2025 FPOT11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
J0160 Program Evaluation Condition
J0161 Program Evaluation Standard
J0162 Program Evaluation Standard
▼ 288547 Park Street Medical Clinic 505 South Park Street Genoa NE 7 (Kansas City) 06/21/2018 MC2V11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0021 Location Of Clinic Standard
J0022 Location Of Clinic Standard
J0023 Location Of Clinic Standard
J0057 Patient Care Policies Standard
J0070 Records System Standard
▼ 288551 Main Street Medical Clinic 313 North Webster, P O Box 467 Red Cloud NE 7 (Kansas City) 06/21/2018 WZ0E11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0037 Staffing and Staff Responsibilities Condition
J0039 Staffing Standard
J0048 Physician Responsibilities Standard