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
▼ 513884 Braxton Primary Health Care 110 Municipal Street Burnsville WV 3 (Philadelphia) 01/11/2018 R7TP11 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
▼ 513889 Bradshaw Medical Clinic 9981 Marshall Highway Bradshaw WV 3 (Philadelphia) 09/18/2019 NEEZ11 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
▼ 513891 Jana Peters Do 365 Courthouse Road Princeton WV 3 (Philadelphia) 10/28/2020 QCG011 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
▼ 513893 Summersville Pediatrics, Inc 400 Fairview Heights Road Summersville WV 3 (Philadelphia) 11/12/2019 P68211 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
J0043 Physical Plant And Environment Standard
J0123 Staffing And Staff Responsibilities Standard
J0125 Provision Of Services Standard
▼ 513897 Harpers Ferry Family Medicine 171 Taylor Street Harpers Ferry WV 3 (Philadelphia) 03/30/2023 WJXR11 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
E0004 Develop Ep Plan, Review And Update Annually Standard
E0006 Plan Based On All Hazards Risk Assessment Standard
E0007 Ep Program Patient Population Standard
E0013 Development Of Ep Policies And Procedures Standard
E0022 Policies/Procedures For Sheltering In Place Standard
E0023 Policies/Procedures For Medical Documentation Standard
E0024 Policies/Procedures-Volunteers And Staffing Standard
E0033 Methods For Sharing Information Standard
E0034 Information On Occupancy/Needs Standard
E0036 Ep Training And Testing Standard
E0037 Ep Training Program Standard
E0039 Ep Testing Requirements Standard
J0124 Provision Of Services Standard
J0135 Provision Of Services Standard
J0161 Program Evaluation Standard
J0162 Program Evaluation Standard
▼ 513900 Family Healthcare Associates 114 Main Street Man WV 3 (Philadelphia) 04/30/2019 7QX811 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
J0042 Physical Plant And Environment Standard
J0123 Staffing And Staff Responsibilities Standard
J0125 Provision Of Services Standard
J0151 Patient Health Records Standard
▼ 513905 Family Healthcare Associates 1061 Larry Joe Harless Drive Gilbert WV 3 (Philadelphia) 04/29/2019 3DWH11 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
J0042 Physical Plant And Environment Standard
▼ 513907 Yukon Medical Clinic 402 Marshall Highway War WV 3 (Philadelphia) 09/17/2019 3MH711 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
▼ 513912 Mountaineer Healthcare Pllc 83 Summers Hospital Road, Suite 105 Hinton WV 3 (Philadelphia) 04/09/2019 0WJ611 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
▼ 513917 Bluewell Family Clinic 154 Majestic Place Bluefield WV 3 (Philadelphia) 09/29/2020 NH1I11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
J0135 Provision Of Services Standard
J0136 Provision Of Services Standard