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
▼ 388529 Samaritan Toledo Clinic 199 West Highway 20 Toledo OR 10 (Seattle) 10/17/2024 4JY811 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
E0039 Ep Testing Requirements Standard
J0041 Physical Plant And Environment Standard
J0043 Physical Plant And Environment Standard
J0101 Staffing And Staff Responsibilities Standard
▼ 388530 Providence Seaside Hospital-Providence Warrenton C 171 S Highway 101 Warrenton OR 10 (Seattle) 03/01/2024 K94Z11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
E0039 Ep Testing Requirements Standard
J0041 Physical Plant And Environment Standard
J0043 Physical Plant And Environment Standard
J0101 Staffing And Staff Responsibilities Standard
J0152 Patient Health Records Standard
J0161 Program Evaluation Standard
▼ 388531 Samaritan Depoe Bay Clinic 531 N Highway 101, Suite A Depoe Bay OR 10 (Seattle) 10/11/2024 YRII11 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
J0043 Physical Plant And Environment Standard
J0100 Staffing And Staff Responsibilities Standard
▼ 388532 Samaritan Health Center-Newport 930 Sw Abbey Street, Suite A Newport OR 10 (Seattle) 10/10/2024 601O11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
J0152 Patient Health Records Standard
▼ 388533 Adventist Health Tillamook Medical Group Estacada 200 Se Hwy 224 Estacada OR 10 (Seattle) 03/20/2025 17LN11 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
J0136 Provision Of Services Standard
▼ 388534 Adventist Health Tillamook Medical Group Hoodland 24461 Welches Road Welches OR 10 (Seattle) 06/28/2018 986S11 Standard
Deficiency Tag Deficiency Description Tag Type
J0000 Initial Comments - Not A Deficiency Citation Memo
E0020 Policies For Evac. And Primary/Alt. Comm. Standard
▼ 388535 Santiam Medical Associates 1401 N 10th Avenue, Suite 100 Stayton OR 10 (Seattle) 08/20/2025 F0RQ11 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
E0039 Ep Testing Requirements Standard
J0041 Physical Plant And Environment Standard
J0042 Physical Plant And Environment Standard
J0101 Staffing And Staff Responsibilities Standard
J0123 Staffing And Staff Responsibilities Standard
J0161 Program Evaluation Standard
▼ 388536 Santiam Internal Medicine Clinic 1401 N 10th Avenue, Suite 200 Stayton OR 10 (Seattle) 08/19/2025 J8ZZ11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
E0039 Ep Testing Requirements Standard
J0041 Physical Plant And Environment Standard
J0101 Staffing And Staff Responsibilities Standard
J0123 Staffing And Staff Responsibilities Standard
J0161 Program Evaluation Standard
▼ 388537 Samaritan Lebanon Medical Clinic Sweet Home 1289 49th Avenue Sweet Home OR 10 (Seattle) 06/18/2025 UP1V11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
J0101 Staffing And Staff Responsibilities Standard
▼ 388538 Main Street Clinic 191 N Main Street Lebanon OR 10 (Seattle) 06/10/2025 MN3T11 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