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
▼ 433802 Monument Health Wall Clinic 112 7th Avenue Wall SD 8 (Denver) 03/05/2020 4YG311 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
▼ 433827 Sanford Clinic Lennox 108 S Main Post Office Box 662 Lennox SD 8 (Denver) 02/12/2024 MG2211 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
▼ 433878 Mcgreevy Clinic Salem 740 South Hill Salem SD 8 (Denver) 01/25/2018 2I3J11 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
J0076 Program Evaluation Condition
▼ 433886 Avera Medical Group Waubay 80 N Main Street Po Box 215 Waubay SD 8 (Denver) 08/01/2023 URIK11 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
J0125 Provision Of Services Standard
▼ 433890 Monument Health Medical Clinic 1100 Hwy 71 S Suite 101 Hot Springs SD 8 (Denver) 03/06/2019 K5X911 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
J0101 Staffing And Staff Responsibilities Standard
J0123 Staffing And Staff Responsibilities Standard
J0161 Program Evaluation Standard
J0162 Program Evaluation Standard
▼ 443438 Johnson County Medical Group 1901 S Shady Street Mountain City TN 4 (Atlanta) 11/08/2021 VQLH11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
J0151 Patient Health Records Standard
▼ 443447 Henderson County Medical Group Rhc 270 West Church Street Lexington TN 4 (Atlanta) 04/29/2024 V1PJ11 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
J0161 Program Evaluation Standard
J0162 Program Evaluation Standard
▼ 443447 Henderson County Medical Group Rhc 270 West Church Street Lexington TN 4 (Atlanta) 03/28/2018 PL2Z11 Standard
Deficiency Tag Deficiency Description Tag Type
J0000 Initial Comments - Not A Deficiency Citation Memo
E0001 Establishment Of The Emergency Program (Ep) Condition
E0007 Ep Program Patient Population Standard
E0009 Local, State, Tribal Collaboration Process Standard
E0013 Development Of Ep Policies And Procedures Standard
E0024 Policies/Procedures-Volunteers And Staffing Standard
E0029 Development Of Communication Plan Standard
▼ 443471 Ascension Saint Thomas Three Rivers Primary Care 451 Highway 13 S Waverly TN 4 (Atlanta) 03/04/2026 BCG511 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
E0006 Plan Based On All Hazards Risk Assessment Standard
E0037 Ep Training Program Standard
J0161 Program Evaluation Standard
J0162 Program Evaluation Standard
▼ 443916 Cookeville Medical Clinic Rhc 225 North Willow Avenue Ste 3 Cookeville TN 4 (Atlanta) 07/17/2019 BIEU11 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