S&C QCOR RHC 2567s
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RHCs 2567s
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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
▼ 043852 Mayflower Medical Clinic 606 Highway 365 Mayflower AR 6 (Dallas) 11/16/2018 1J0U11 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
E0009 Local, State, Tribal Collaboration Process Standard
E0024 Policies/Procedures-Volunteers And Staffing Standard
E0030 Names And Contact Information Standard
E0031 Emergency Officials Contact Information Standard
E0034 Information On Occupancy/Needs Standard
E0037 Ep Training Program Standard
J0042 Physical Plant And Environment Standard
J0043 Physical Plant And Environment Standard
J0100 Staffing And Staff Responsibilities Standard
▼ 043853 Banister Lieblong Clinic 2425 Dave Ward Drive, #401 Conway AR 6 (Dallas) 02/01/2018 1NSW12 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
J0061 Organizational Structure Standard
▼ 043854 Greenbrier Family Medicine 110 North Broadview Greenbrier AR 6 (Dallas) 05/15/2018 0V3W11 Standard
Deficiency Tag Deficiency Description Tag Type
J0000 Initial Comments - Not A Deficiency Citation Memo
E0020 Policies For Evac. And Primary/Alt. Comm. Standard
E0022 Policies/Procedures For Sheltering In Place Standard
E0023 Policies/Procedures For Medical Documentation Standard
E0024 Policies/Procedures-Volunteers And Staffing Standard
J0023 Location Of Clinic Standard
J0024 Location Of Clinic Standard
J0047 Physician Responsibilities Standard
J0057 Patient Care Policies Standard
J0068 Records System Standard
J0081 Staffing And Staff Responsibilities Standard
▼ 043856 Wagner Medical Clinic 3644 West Hwy 18 Manila AR 6 (Dallas) 12/26/2018 L1YS11 Standard
Deficiency Tag Deficiency Description Tag Type
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
E0009 Local, State, Tribal Collaboration Process Standard
E0013 Development Of Ep Policies And Procedures Standard
E0022 Policies/Procedures For Sheltering In Place 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
E0036 Ep Training And Testing Standard
E0037 Ep Training Program Standard
E0039 Ep Testing Requirements Standard
J0041 Physical Plant And Environment Standard
J0042 Physical Plant And Environment Standard
J0044 Physical Plant And Environment Standard
J0125 Provision Of Services Standard
J0135 Provision Of Services Standard
J0136 Provision Of Services Standard
J0151 Patient Health Records Standard
J0152 Patient Health Records Standard
J0161 Program Evaluation Standard
▼ 043861 Pillow Clinic, Pllc 101 Shirley Hicks Drive Helena AR 6 (Dallas) 04/27/2018 ZFG911 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
E0009 Local, State, Tribal Collaboration Process Standard
E0030 Names And Contact Information Standard
E0031 Emergency Officials Contact Information Standard
E0034 Information On Occupancy/Needs Standard
E0037 Ep Training Program Standard
E0039 Ep Testing Requirements Standard
J0022 Location Of Clinic Standard
J0047 Physician Responsibilities Standard
J0051 Physician Assistant/Nurse Practitioner Responsibilities Standard
J0056 Patient Care Policies Standard
J0057 Patient Care Policies Standard
J0058 Patient Care Policies Standard
J0062 Organizational Structure Standard
J0077 Annual Total Program Evaluation Standard
▼ 043863 Webber Family Practice 504 Pecan Street Helena AR 6 (Dallas) 08/14/2019 PK0111 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
J0043 Physical Plant And Environment Standard
J0044 Physical Plant And Environment Standard
J0136 Provision Of Services Standard
J0151 Patient Health Records Standard
J0152 Patient Health Records Standard
▼ 043864 Baxter County Regional Hospital Inc. 350 South Main, Suite 4 Mammoth Spring AR 6 (Dallas) 05/06/2021 62MQ11 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
▼ 043874 Uams Family Medical Clinic-Magnolia 1617 North Washington Magnolia AR 6 (Dallas) 08/13/2024 9WUN11 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
J0101 Staffing And Staff Responsibilities Standard
J0151 Patient Health Records Standard
J0152 Patient Health Records Standard
▼ 043875 Fore Family Practice Llc 307 North Main Street Cave City AR 6 (Dallas) 08/26/2025 PKYO11 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
J0044 Physical Plant And Environment Standard
▼ 043877 Access Medical Clinic 3519 Highway 63 Black Rock AR 6 (Dallas) 01/13/2022 48QV11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
J0013 Licensure/Cert/Registration Of Personnel Standard
J0123 Staffing And Staff Responsibilities Standard
J0124 Provision Of Services Standard
J0125 Provision Of Services Standard