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
▼ 528549 Mile Bluff Clinic 1040 Division St Mauston WI 5 (Chicago) 04/03/2018 YIPX11 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
J0024 Location Of Clinic Standard
J0054 Patient Care Policies Standard
J0061 Organizational Structure Standard
J0069 Records System Standard
J0070 Records System Standard
J0072 Protection of Record Information Standard
▼ 528551 Gundersen Tri County Hsptl & Clinics Independence 35791 Osseo Rd Independence WI 5 (Chicago) 07/14/2021 5PFC11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
J0101 Staffing And Staff Responsibilities Standard
J0135 Provision Of Services Standard
▼ 528554 Bellin Health Oconto Clinic 820 Arbitus Ave Oconto WI 5 (Chicago) 09/19/2022 DHOB11 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
J0152 Patient Health Records Standard
▼ 528571 Cumberland Hc Turtle Lake Center 632 Us Highway 8 Cumberland WI 5 (Chicago) 03/11/2019 DLPQ11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
E0006 Plan Based On All Hazards Risk Assessment Standard
J0044 Physical Plant And Environment Standard
▼ 528578 Bellin Health Marinette 2820 Roosevelt Road Marinette WI 5 (Chicago) 09/09/2020 GEKH11 Complaint, Special, 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
J0152 Patient Health Records Standard
▼ 528579 Bellin Health Crivitz 218 S Us Hwy 141 Crivitz WI 5 (Chicago) 02/24/2020 9PI011 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
E0020 Policies For Evac. And Primary/Alt. Comm. Standard
▼ 528580 Bellin Health Peshtigo 441 French St Peshtigo WI 5 (Chicago) 05/29/2024 7TCM11 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
▼ 528643 Krohn Clinic 610 W Adams St Black River Falls WI 5 (Chicago) 09/07/2023 XD9Q11 Complaint
Deficiency Tag Deficiency Description Tag Type
J0000 Initial Comments - Not A Deficiency Citation Memo
J0001 Certification Procedures Condition
J0003 Certification Procedures Standard
▼ 533803 Medicine Bow Health Center 514 Idaho Drive Medicine Bow WY 8 (Denver) 09/05/2018 4VOD11 Standard
Deficiency Tag Deficiency Description Tag Type
J0000 Initial Comments - Not A Deficiency Citation Memo
J0023 Location Of Clinic Standard
▼ 533806 Weston County Hospital District 1121 Washington Blvd Newcastle WY 8 (Denver) 07/02/2019 GJSK11 Standard
Deficiency Tag Deficiency Description Tag Type
J0000 Initial Comments - Not A Deficiency Citation Memo
J0160 Program Evaluation Condition
J0123 Staffing And Staff Responsibilities Standard
J0161 Program Evaluation Standard