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
▼ 448997 Restoration Clinic 17619 State Highway 58 North, Ste C Decatur TN 4 (Atlanta) 08/07/2018 IPMN11 Standard
Deficiency Tag Deficiency Description Tag Type
J0000 Initial Comments - Not A Deficiency Citation Memo
E0001 Establishment Of The Emergency Program (Ep) Condition
J0019 Physical Plant And Environment Condition
J0042 Physical Plant And Environment Standard
J0045 Physician Responsibilities Standard
▼ 448998 Mid-South Convenient Care Pllc 1445 Us Highway 51 Bypass E, Suite B Dyersburg TN 4 (Atlanta) 09/19/2018 5F5L11 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
E0030 Names And Contact Information Standard
E0031 Emergency Officials Contact Information Standard
E0037 Ep Training Program Standard
E0039 Ep Testing Requirements Standard
J0067 Records System Standard
▼ 453413 Baylor Scott & White Clinic-Llano 102 E Young Llano TX 6 (Dallas) 05/29/2018 2UPY11 Standard
Deficiency Tag Deficiency Description Tag Type
J0000 Initial Comments - Not A Deficiency Citation Memo
E0032 Primary/Alternate Means For Communication Standard
J0021 Location Of Clinic Standard
J0023 Location Of Clinic Standard
▼ 453426 Christus Family Practice Center - Kirbyville 205 E Lavielle Kirbyville TX 6 (Dallas) 03/19/2019 NOPE11 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
▼ 453441 Refugio Rhc 107 Swift St Refugio TX 6 (Dallas) 11/08/2022 9J3411 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
▼ 453462 Van Horn Rhc Eisenhower & Fm 2185 Van Horn TX 6 (Dallas) 02/19/2019 TC1Z11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
E0009 Local, State, Tribal Collaboration Process Standard
E0022 Policies/Procedures For Sheltering In Place Standard
J0043 Physical Plant And Environment Standard
▼ 453463 Mid Coast Medical Clinic 305 Sandy Corner Road, Suite 120 El Campo TX 6 (Dallas) 06/20/2018 KLKB11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
J0022 Location Of Clinic Standard
J0023 Location Of Clinic Standard
▼ 453466 Medical Arts Clinic 2202 N Bryan Avenue Lamesa TX 6 (Dallas) 01/23/2018 35JA11 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
▼ 453480 Christus Se Texas Family Practice Center-Jasper 1276 S Peachtree St Jasper TX 6 (Dallas) 10/24/2018 6LS511 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
J0100 Staffing And Staff Responsibilities Standard
J0102 Staffing And Staff Responsibilities Standard
J0123 Staffing And Staff Responsibilities Standard
J0125 Provision Of Services Standard
J0153 Patient Health Records Standard
J0161 Program Evaluation Standard
▼ 453812 Family Health Center L L P 2768 Pharmacy Road Rio Grande City TX 6 (Dallas) 05/22/2018 4J9Z11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
J0019 Physical Plant And Environment Condition
E0004 Develop Ep Plan, Review And Update Annually Standard
E0009 Local, State, Tribal Collaboration Process Standard
E0032 Primary/Alternate Means For Communication Standard
J0022 Location Of Clinic Standard
J0023 Location Of Clinic Standard
J0024 Location Of Clinic Standard
J0061 Organizational Structure Standard
J0070 Records System Standard
J0072 Protection of Record Information Standard