S&C QCOR RHC 2567s
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RHCs 2567s
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Time Interval

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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
▼ 353977 Nelson County Health System - Mcville Clinic 108 N Main St Mcville ND 8 (Denver) 01/29/2020 BKI711 Standard
Deficiency Tag Deficiency Description Tag Type
E0037 Ep Training Program Standard
J0042 Physical Plant And Environment Standard
▼ 353978 Unity Medical Center/Grafton Family Clinic 155 W 14th St Grafton ND 8 (Denver) 02/23/2021 8PU311 Special, Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
J0135 Provision Of Services Standard
J0136 Provision Of Services Standard
▼ 353979 Dakota Regional Medical Center Clinic 107 12th St S Cooperstown ND 8 (Denver) 06/28/2023 893211 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0136 Provision Of Services Standard
▼ 353981 West River Health Services New England Clinic 820 2nd Ave W New England ND 8 (Denver) 10/03/2019 6W6J11 Standard
Deficiency Tag Deficiency Description Tag Type
J0042 Physical Plant And Environment Standard
▼ 353982 West River Health Services Bowman Clinic 608 Hwy 12 West Bowman ND 8 (Denver) 10/03/2019 7J5K11 Standard
Deficiency Tag Deficiency Description Tag Type
J0125 Provision Of Services Standard
▼ 353983 West River Health Clinic - Scranton 211 S Main St Scranton ND 8 (Denver) 10/03/2019 4JDJ11 Standard
Deficiency Tag Deficiency Description Tag Type
J0042 Physical Plant And Environment Standard
▼ 353985 Chi St Alexius Health Dickinson Family Clinic 95 2nd St Nw Beach ND 8 (Denver) 07/08/2025 0O3E11 Standard
Deficiency Tag Deficiency Description Tag Type
E0042 Integrated Ep Program Standard
J0043 Physical Plant And Environment Standard
▼ 353985 Chi St Alexius Health Dickinson Family Clinic 95 2nd St Nw Beach ND 8 (Denver) 10/10/2018 HU6J11 Standard
Deficiency Tag Deficiency Description Tag Type
J0043 Physical Plant And Environment Standard
J0123 Staffing And Staff Responsibilities Standard
J0125 Provision Of Services Standard
▼ 353986 Tioga Medical Center Tioga Rhc 810 N Welo St Tioga ND 8 (Denver) 01/31/2018 J8RX11 Standard
Deficiency Tag Deficiency Description Tag Type
J0023 Location Of Clinic Standard
J0057 Patient Care Policies Standard
J0061 Organizational Structure Standard
▼ 353987 Tioga Medical Center - Powers Lake Rhc 117 Main St Powers Lake ND 8 (Denver) 01/07/2026 VRQ611 Standard
Deficiency Tag Deficiency Description Tag Type
E0042 Integrated Ep Program Standard
J0100 Staffing And Staff Responsibilities Standard
J0135 Provision Of Services Standard