S&C QCOR RHC 2567s
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RHCs 2567s
Selection Criteria ▸

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
▼ 383876 North Bend Medical Center Bandon 110 10th Street Se Bandon OR 10 (Seattle) 03/16/2021 1MT711 Special, Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
E0001 Establishment Of The Emergency Program (Ep) Condition
J0040 Physical Plant And Environment Condition
J0120 Provision Of Services Condition
J0160 Program Evaluation Condition
J0041 Physical Plant And Environment Standard
J0043 Physical Plant And Environment Standard
J0044 Physical Plant And Environment Standard
J0101 Staffing And Staff Responsibilities Standard
J0123 Staffing And Staff Responsibilities Standard
J0124 Provision Of Services Standard
J0125 Provision Of Services Standard
J0135 Provision Of Services Standard
J0136 Provision Of Services Standard
J0152 Patient Health Records Standard
▼ 383878 Urgentcare Nw-Astoria 2120 Exchange Street, Suite 111 Astoria OR 10 (Seattle) 02/28/2024 D7M311 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
E0004 Develop Ep Plan, Review And Update Annually Standard
E0006 Plan Based On All Hazards Risk Assessment Standard
E0039 Ep Testing Requirements Standard
J0041 Physical Plant And Environment Standard
J0042 Physical Plant And Environment Standard
J0043 Physical Plant And Environment Standard
J0101 Staffing And Staff Responsibilities Standard
J0161 Program Evaluation Standard
▼ 383880 Evergreen Family Medicine Pc 2570 Nw Edenbower Boulevard, Suite 100 Roseburg OR 10 (Seattle) 09/19/2024 IRG011 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
J0041 Physical Plant And Environment Standard
J0043 Physical Plant And Environment Standard
▼ 383880 Evergreen Family Medicine Pc 2570 Nw Edenbower Boulevard, Suite 100 Roseburg OR 10 (Seattle) 08/10/2020 MVHY11 Complaint
Deficiency Tag Deficiency Description Tag Type
J0000 Initial Comments - Not A Deficiency Citation Memo
J0044 Physical Plant And Environment Standard
▼ 383881 Legacy Medical Group - Firwood 36860 Industrial Way Sandy OR 10 (Seattle) 05/22/2019 FS9W11 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
E0004 Develop Ep Plan, Review And Update Annually Standard
E0006 Plan Based On All Hazards Risk Assessment Standard
E0039 Ep Testing Requirements Standard
J0043 Physical Plant And Environment Standard
J0123 Staffing And Staff Responsibilities Standard
J0152 Patient Health Records Standard
▼ 383882 Columbia Gorge Family Medicine 1750 12th Street Hood River OR 10 (Seattle) 03/27/2019 G5Y611 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
E0004 Develop Ep Plan, Review And Update Annually Standard
J0042 Physical Plant And Environment Standard
J0043 Physical Plant And Environment Standard
J0123 Staffing And Staff Responsibilities Standard
J0152 Patient Health Records Standard
▼ 383883 Canby Health Care Clinic Llc 703 Se 1st Ave Canby OR 10 (Seattle) 03/10/2023 FWDQ11 Complaint
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
E0001 Establishment Of The Emergency Program (Ep) Condition
J0160 Program Evaluation Condition
J0100 Staffing And Staff Responsibilities Standard
J0123 Staffing And Staff Responsibilities Standard
▼ 383883 Canby Health Care Clinic Llc 703 Se 1st Ave Canby OR 10 (Seattle) 03/10/2023 O2MV11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
E0001 Establishment Of The Emergency Program (Ep) Condition
J0160 Program Evaluation Condition
J0100 Staffing And Staff Responsibilities Standard
J0110 Covid-19 Vaccination Of Facility Staff Standard
J0123 Staffing And Staff Responsibilities Standard
▼ 383883 Canby Health Care Clinic Llc 703 Se 1st Ave Canby OR 10 (Seattle) 10/31/2019 QHNQ11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
E0001 Establishment Of The Emergency Program (Ep) Condition
J0040 Physical Plant And Environment Condition
J0160 Program Evaluation Condition
J0041 Physical Plant And Environment Standard
J0042 Physical Plant And Environment Standard
J0043 Physical Plant And Environment Standard
J0044 Physical Plant And Environment Standard
J0123 Staffing And Staff Responsibilities Standard
J0152 Patient Health Records Standard
▼ 383884 Family Health Associates 600 Nw 11th, Suite E-15 Hermiston OR 10 (Seattle) 03/03/2020 FKTE11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
E0001 Establishment Of The Emergency Program (Ep) Condition
J0044 Physical Plant And Environment Standard
J0123 Staffing And Staff Responsibilities Standard
J0161 Program Evaluation Standard