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
▼ 043488 Mercy Hospital Scott Co Rural Health Clinic 1341 West 6th Street Waldron AR 6 (Dallas) 09/18/2024 C6EB11 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
J0152 Patient Health Records Standard
▼ 043489 Baptist Health - Family Clinic Hazen 102 West Front Street Hazen AR 6 (Dallas) 05/07/2025 0XFM11 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
J0140 Provision Of Services Standard
J0152 Patient Health Records Standard
▼ 043491 Mercy Clinic Primary Care - Booneville 128 Daniel Avenue Booneville AR 6 (Dallas) 02/09/2018 O1FD11 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
J0019 Physical Plant And Environment Condition
E0004 Develop Ep Plan, Review And Update Annually Standard
E0006 Plan Based On All Hazards Risk Assessment Standard
E0007 Ep Program Patient Population Standard
E0009 Local, State, Tribal Collaboration Process Standard
E0036 Ep Training And Testing Standard
J0022 Location Of Clinic Standard
J0023 Location Of Clinic Standard
J0024 Location Of Clinic Standard
J0055 Patient Care Policies Standard
J0057 Patient Care Policies Standard
J0061 Organizational Structure Standard
▼ 043492 Baptist Health - Family Clinic Dewitt 1703 South Whitehead Drive De Witt AR 6 (Dallas) 10/02/2018 H53K11 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
E0004 Develop Ep Plan, Review And Update Annually Standard
E0006 Plan Based On All Hazards Risk Assessment Standard
E0007 Ep Program Patient Population Standard
E0022 Policies/Procedures For Sheltering In Place Standard
E0024 Policies/Procedures-Volunteers And Staffing Standard
E0029 Development Of Communication Plan Standard
E0030 Names And Contact Information Standard
E0032 Primary/Alternate Means For Communication Standard
E0036 Ep Training And Testing Standard
E0039 Ep Testing Requirements Standard
E0042 Integrated Ep Program Standard
J0022 Location Of Clinic Standard
J0024 Location Of Clinic Standard
J0055 Patient Care Policies Standard
J0070 Records System Standard
▼ 043493 Mercy Hospital Waldron-Mansfield Family Medicine 100 North Walnut Street, Suite A Mansfield AR 6 (Dallas) 02/05/2019 CQB711 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
E0007 Ep Program Patient Population Standard
E0022 Policies/Procedures For Sheltering In Place Standard
E0024 Policies/Procedures-Volunteers And Staffing Standard
E0030 Names And Contact Information Standard
E0042 Integrated Ep Program Standard
J0135 Provision Of Services Standard
J0136 Provision Of Services Standard
J0152 Patient Health Records Standard
J0161 Program Evaluation Standard
▼ 043494 Dallas County Medical Center Family Clinic 201 North Clifton Street Fordyce AR 6 (Dallas) 10/20/2020 J5G811 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
▼ 043497 Irh Medical Group-Grasse Family Medicine 61 Grasse Street Calico Rock AR 6 (Dallas) 12/15/2022 Z60411 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
J0152 Patient Health Records Standard
▼ 043802 St Elizabeth Health Center 407 South Gould Avenue Gould AR 6 (Dallas) 05/20/2019 G24V11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
J0120 Provision Of Services Condition
E0004 Develop Ep Plan, Review And Update Annually Standard
E0009 Local, State, Tribal Collaboration Process Standard
E0024 Policies/Procedures-Volunteers And Staffing Standard
E0029 Development Of Communication Plan Standard
E0031 Emergency Officials Contact Information Standard
E0032 Primary/Alternate Means For Communication Standard
J0044 Physical Plant And Environment Standard
J0123 Staffing And Staff Responsibilities Standard
J0125 Provision Of Services Standard
J0136 Provision Of Services Standard
▼ 043808 De Paul Community Health Centers - Dumas 145 West Waterman Street Dumas AR 6 (Dallas) 03/23/2021 MJL811 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
J0152 Patient Health Records Standard
▼ 043812 Decatur Medi-Clinic 346 North Main Decatur AR 6 (Dallas) 04/20/2021 WB2X11 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
J0153 Patient Health Records Standard