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
▼ 428988 Lake City Family Medicine, Llc 901 N Matthews Road Lake City SC 4 (Atlanta) 03/07/2023 GBO311 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
J0043 Physical Plant And Environment Standard
J0101 Staffing And Staff Responsibilities Standard
J0161 Program Evaluation Standard
▼ 428988 Lake City Family Medicine, Llc 901 N Matthews Road Lake City SC 4 (Atlanta) 11/26/2019 4VIC11 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
J0062 Organizational Structure Standard
J0101 Staffing And Staff Responsibilities Standard
J0123 Staffing And Staff Responsibilities Standard
J0124 Provision Of Services Standard
J0125 Provision Of Services Standard
J0136 Provision Of Services Standard
J0151 Patient Health Records Standard
J0152 Patient Health Records Standard
▼ 428989 Mcleod Family Medicine - Johnsonville 355 South Georgetown Highway Johnsonville SC 4 (Atlanta) 11/12/2019 Q5CY11 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
E0031 Emergency Officials Contact Information Standard
E0037 Ep Training Program Standard
J0044 Physical Plant And Environment Standard
J0152 Patient Health Records Standard
▼ 428990 Blythewood Medical Associates 428 - 2 Mcnulty Road Blythewood SC 4 (Atlanta) 09/12/2023 8EZ711 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
J0101 Staffing And Staff Responsibilities Standard
J0124 Provision Of Services Standard
J0125 Provision Of Services Standard
J0152 Patient Health Records Standard
▼ 428990 Blythewood Medical Associates 428 - 2 Mcnulty Road Blythewood SC 4 (Atlanta) 12/23/2019 CTC711 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
E0031 Emergency Officials Contact Information Standard
E0037 Ep Training Program Standard
J0043 Physical Plant And Environment Standard
J0061 Organizational Structure Standard
J0151 Patient Health Records Standard
J0152 Patient Health Records Standard
▼ 428995 Landrum Family Health Care Llc 108 W Rutherford Street Landrum SC 4 (Atlanta) 11/12/2019 253511 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
E0029 Development Of Communication Plan Standard
E0030 Names And Contact Information Standard
E0031 Emergency Officials Contact Information Standard
E0032 Primary/Alternate Means For Communication Standard
E0036 Ep Training And Testing Standard
E0037 Ep Training Program Standard
E0039 Ep Testing Requirements Standard
J0042 Physical Plant And Environment Standard
J0044 Physical Plant And Environment Standard
J0125 Provision Of Services Standard
J0152 Patient Health Records Standard
J0154 Patient Health Records Standard
▼ 433408 Avera St Benedict Crhc/Lake Andes 756 E Lake Po Box 279 Lake Andes SD 8 (Denver) 04/25/2019 R8D011 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
J0162 Program Evaluation Standard
▼ 433410 Avera St Benedict Crhc/Tripp 306 South Main Street Tripp SD 8 (Denver) 06/20/2019 SXZ111 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
J0085 Staffing And Staff Responsibilities Standard
▼ 433411 Philip Clinic 503 W Pine St Po Box 550 Philip SD 8 (Denver) 02/04/2020 RPU011 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
J0135 Provision Of Services Standard
J0161 Program Evaluation Standard
J0162 Program Evaluation Standard
▼ 433413 Avera Medical Group Revillo 305 N 2nd Avenue Revillo SD 8 (Denver) 02/13/2018 FRI311 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
J0021 Location Of Clinic Standard