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
▼ 388509 Samaritan Lincoln City Medical Center 2870 West Devils Lake Road Lincoln City OR 10 (Seattle) 06/04/2019 OX3G11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
E0037 Ep Training Program Standard
J0042 Physical Plant And Environment Standard
J0044 Physical Plant And Environment Standard
▼ 388510 Adventist Health Tillamook Medical Group Manzanita 10445 Neahkahnie Creek Road Manzanita OR 10 (Seattle) 07/24/2019 HB5U11 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
J0042 Physical Plant And Environment Standard
J0043 Physical Plant And Environment Standard
▼ 388512 Harney District Hospital Family Care 559 W Washington Street Burns OR 10 (Seattle) 07/26/2021 D6KY11 Special, Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
J0013 Licensure/Cert/Registration Of Personnel Standard
J0084 Staffing And Staff Responsibilities Standard
J0123 Staffing And Staff Responsibilities Standard
▼ 388513 Dunes Family Health Care 620 Ranch Road Reedsport OR 10 (Seattle) 05/26/2021 IETB11 Special, 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
E0037 Ep Training Program Standard
E0039 Ep Testing Requirements Standard
J0041 Physical Plant And Environment Standard
J0101 Staffing And Staff Responsibilities Standard
J0123 Staffing And Staff Responsibilities Standard
J0152 Patient Health Records Standard
▼ 388514 Adventist Health Bayshore Medical Pacific City 38505 Brooten Rd Pacific City OR 10 (Seattle) 03/21/2024 LW6911 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
E0006 Plan Based On All Hazards Risk Assessment Standard
J0152 Patient Health Records Standard
▼ 388515 Cmh Primary Clinic 1639 Se Ensign Lane, Suite B 103 Warrenton OR 10 (Seattle) 10/16/2020 QWG411 Special, Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
J0042 Physical Plant And Environment Standard
J0043 Physical Plant And Environment Standard
J0101 Staffing And Staff Responsibilities Standard
J0123 Staffing And Staff Responsibilities Standard
J0124 Provision Of Services Standard
▼ 388516 Adventist Health Bayshore Medical Lincoln City 1105 Southeast Jetty Avenue Suite C Lincoln City OR 10 (Seattle) 08/23/2023 0U1G11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
J0020 Location Of Clinic Condition
J0023 Location Of Clinic Standard
J0041 Physical Plant And Environment Standard
J0101 Staffing And Staff Responsibilities Standard
J0123 Staffing And Staff Responsibilities Standard
J0152 Patient Health Records Standard
J0161 Program Evaluation Standard
▼ 388516 Adventist Health Bayshore Medical Lincoln City 1105 Southeast Jetty Avenue Suite C Lincoln City OR 10 (Seattle) 08/23/2023 IEO611 Complaint
Deficiency Tag Deficiency Description Tag Type
J0000 Initial Comments - Not A Deficiency Citation Memo
J0020 Location Of Clinic Condition
J0023 Location Of Clinic Standard
J0041 Physical Plant And Environment Standard
J0101 Staffing And Staff Responsibilities Standard
J0123 Staffing And Staff Responsibilities Standard
J0152 Patient Health Records Standard
J0161 Program Evaluation Standard
▼ 388517 Lake Health District 700 South J Street Lakeview OR 10 (Seattle) 08/02/2022 GB9A11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
E0042 Integrated Ep Program Standard
J0013 Licensure/Cert/Registration Of Personnel Standard
J0044 Physical Plant And Environment Standard
J0110 Covid-19 Vaccination Of Facility Staff Standard
J0123 Staffing And Staff Responsibilities Standard
J0152 Patient Health Records Standard
J0161 Program Evaluation Standard
J0162 Program Evaluation Standard
▼ 388518 Ione Community Clinic 365 W 3rd Street Ione OR 10 (Seattle) 08/08/2024 T7M311 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
J0080 Staffing And Staff Responsibilities Condition
E0004 Develop Ep Plan, Review And Update Annually Standard
E0006 Plan Based On All Hazards Risk Assessment Standard
E0039 Ep Testing Requirements Standard
E0042 Integrated Ep Program Standard
J0041 Physical Plant And Environment Standard
J0100 Staffing And Staff Responsibilities Standard
J0101 Staffing And Staff Responsibilities Standard
J0123 Staffing And Staff Responsibilities Standard
J0161 Program Evaluation Standard