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
▼ 673886 Christus Trinity Clinic 5321 Fm 14/2869 Hawkins TX 6 (Dallas) 07/17/2018 DPLO11 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
E0009 Local, State, Tribal Collaboration Process Standard
J0023 Location Of Clinic Standard
J0057 Patient Care Policies Standard
▼ 673887 Steve Ahmed, Md, Pa 1700 W Fm 700 Big Spring TX 6 (Dallas) 06/19/2018 NVE911 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
E0006 Plan Based On All Hazards Risk Assessment Standard
E0009 Local, State, Tribal Collaboration Process Standard
E0020 Policies For Evac. And Primary/Alt. Comm. Standard
E0023 Policies/Procedures For Medical Documentation Standard
E0024 Policies/Procedures-Volunteers And Staffing Standard
E0032 Primary/Alternate Means For Communication Standard
E0034 Information On Occupancy/Needs Standard
J0023 Location Of Clinic Standard
J0024 Location Of Clinic Standard
J0061 Organizational Structure Standard
▼ 673889 Crane Medical Clinic Pa 102 S Gaston St Crane TX 6 (Dallas) 07/31/2018 7K8611 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
J0003 Certification Procedures Condition
J0020 Location Of Clinic Condition
E0006 Plan Based On All Hazards Risk Assessment Standard
E0009 Local, State, Tribal Collaboration Process Standard
E0023 Policies/Procedures For Medical Documentation Standard
E0024 Policies/Procedures-Volunteers And Staffing Standard
E0029 Development Of Communication Plan Standard
E0030 Names And Contact Information Standard
E0036 Ep Training And Testing Standard
E0039 Ep Testing Requirements Standard
J0023 Location Of Clinic Standard
J0054 Patient Care Policies Standard
J0057 Patient Care Policies Standard
J0058 Patient Care Policies Standard
J0072 Protection of Record Information Standard
J0077 Annual Total Program Evaluation Standard
▼ 673893 Pediatric Practice Association - Roma 1505 N Grant St Ste 1 Roma TX 6 (Dallas) 07/17/2018 KBS911 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
E0006 Plan Based On All Hazards Risk Assessment Standard
E0009 Local, State, Tribal Collaboration Process Standard
E0023 Policies/Procedures For Medical Documentation Standard
E0024 Policies/Procedures-Volunteers And Staffing Standard
E0031 Emergency Officials Contact Information Standard
E0032 Primary/Alternate Means For Communication Standard
E0034 Information On Occupancy/Needs Standard
E0039 Ep Testing Requirements Standard
J0023 Location Of Clinic Standard
J0061 Organizational Structure Standard
▼ 673895 One Source Health Center, Earl 2005 Hwy 183 N Early TX 6 (Dallas) 04/10/2018 YL3Y11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
J0020 Location Of Clinic Condition
E0004 Develop Ep Plan, Review And Update Annually Standard
E0024 Policies/Procedures-Volunteers And Staffing Standard
E0032 Primary/Alternate Means For Communication Standard
E0037 Ep Training Program Standard
J0023 Location Of Clinic Standard
J0046 Physician Responsibilities Standard
J0057 Patient Care Policies Standard
J0068 Records System Standard
J0070 Records System Standard
J0078 Evaluation Review Criteria Standard
▼ 673899 Fred Health Care Pllc 20290 S Fm 92 Fred TX 6 (Dallas) 01/14/2020 MPUX11 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
J0040 Physical Plant And Environment Condition
E0006 Plan Based On All Hazards Risk Assessment Standard
E0007 Ep Program Patient Population Standard
E0009 Local, State, Tribal Collaboration Process Standard
E0024 Policies/Procedures-Volunteers And Staffing Standard
E0032 Primary/Alternate Means For Communication Standard
E0033 Methods For Sharing Information Standard
E0034 Information On Occupancy/Needs Standard
E0039 Ep Testing Requirements Standard
J0041 Physical Plant And Environment Standard
J0042 Physical Plant And Environment Standard
J0043 Physical Plant And Environment Standard
J0135 Provision Of Services Standard
J0136 Provision Of Services Standard
J0152 Patient Health Records Standard
▼ 673902 Campbell Clinic 1517 Texas Drive Weatherford TX 6 (Dallas) 02/25/2025 RDOQ11 Complaint
Deficiency Tag Deficiency Description Tag Type
J0000 Initial Comments - Not A Deficiency Citation Memo
J0042 Physical Plant And Environment Standard
J0043 Physical Plant And Environment Standard
▼ 673919 Puckett Family Clinic, Pc 1301 East Main Street Honey Grove TX 6 (Dallas) 04/10/2018 C48111 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
J0022 Location Of Clinic Standard
J0023 Location Of Clinic Standard
J0078 Evaluation Review Criteria Standard
▼ 673941 Stamford Family Health Center 1601 Columbia Street, Suite A Stamford TX 6 (Dallas) 04/03/2018 B9I011 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
J0076 Program Evaluation Condition
J0024 Location Of Clinic Standard
▼ 673992 Covenant Healthcare Center Plainview 2222 W 24th St Suite 6 Plainview TX 6 (Dallas) 01/15/2019 HC1311 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
E0039 Ep Testing Requirements Standard
J0152 Patient Health Records Standard