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
▼ 033998 Community Hospital Clinic - Wickenburg 523 Rose Lane Wickenburg AZ 9 (San Francisco) 06/05/2019 S42T11 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
▼ 033999 Bouse Medical Clinic 44031 East Plomosa Road, Box 866 Bouse AZ 9 (San Francisco) 04/07/2022 OX0O11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
J0044 Physical Plant And Environment Standard
J0135 Provision Of Services Standard
▼ 038502 Community Hospital Clinic-Congress 26750 B South Santa Fe Road Congress AZ 9 (San Francisco) 03/23/2021 HVNG11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
J0044 Physical Plant And Environment Standard
J0125 Provision Of Services Standard
▼ 038502 Community Hospital Clinic-Congress 26750 B South Santa Fe Road Congress AZ 9 (San Francisco) 02/20/2018 8MD211 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
E0022 Policies/Procedures For Sheltering In Place Standard
▼ 038503 Copper Mountain Clinic 2175 W 16th Street Suite D Safford AZ 9 (San Francisco) 10/22/2024 K6AX11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
J0136 Provision Of Services Standard
▼ 038503 Copper Mountain Clinic 2175 W 16th Street Suite D Safford AZ 9 (San Francisco) 01/31/2018 T4VF12 Standard
Deficiency Tag Deficiency Description Tag Type
J0076 Program Evaluation Condition
J0077 Annual Total Program Evaluation Standard
▼ 038509 White Mountain Regional Medical Center Clinic 114 South Mountain Avenue Springerville AZ 9 (San Francisco) 01/04/2021 DW5P11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
J0011 Compliance With Fed., State & Local Laws Standard
▼ 038509 White Mountain Regional Medical Center Clinic 114 South Mountain Avenue Springerville AZ 9 (San Francisco) 06/07/2018 AHLB11 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
▼ 043423 Newton County Family Practice Clinic 502 West Court Street Jasper AR 6 (Dallas) 01/03/2018 TKS711 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
J0023 Location Of Clinic Standard
J0070 Records System Standard
▼ 043432 Baxter Regional Ahrens Clinic 414 West Old Main Street Yellville AR 6 (Dallas) 07/02/2018 732V11 Standard
Deficiency Tag Deficiency Description Tag Type
J0000 Initial Comments - Not A Deficiency Citation Memo
J0076 Program Evaluation Condition
E0024 Policies/Procedures-Volunteers And Staffing Standard
E0042 Integrated Ep Program Standard
J0023 Location Of Clinic Standard
J0024 Location Of Clinic Standard
J0047 Physician Responsibilities Standard
J0048 Physician Responsibilities Standard
J0051 Physician Assistant/Nurse Practitioner Responsibilities Standard
J0055 Patient Care Policies Standard
J0056 Patient Care Policies Standard
J0058 Patient Care Policies Standard
J0062 Organizational Structure Standard
J0070 Records System Standard
J0078 Evaluation Review Criteria Standard
J0086 Staffing And Staff Responsibilities Standard