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
▼ 103449 Adventheatlh Family And Lifestyle Medicine Avon Pk 1006 W Pleasant St Avon Park FL 4 (Atlanta) 08/15/2019 5Z1L11 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
E0013 Development Of Ep Policies And Procedures Standard
E0042 Integrated Ep Program Standard
J0136 Provision Of Services Standard
J0161 Program Evaluation Standard
J0162 Program Evaluation Standard
▼ 103452 Ascension Sacred Heart Gulf 55 Ave E Apalachicola FL 4 (Atlanta) 05/05/2025 6X0211 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
J0136 Provision Of Services Standard
J0161 Program Evaluation Standard
▼ 103452 Ascension Sacred Heart Gulf 55 Ave E Apalachicola FL 4 (Atlanta) 08/22/2018 XCTM11 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
E0029 Development Of Communication Plan Standard
E0039 Ep Testing Requirements Standard
J0047 Physician Responsibilities Standard
J0051 Physician Assistant/Nurse Practitioner Responsibilities Standard
J0058 Patient Care Policies Standard
J0077 Annual Total Program Evaluation Standard
▼ 103459 Weems Medical Center East 110 Ne 5th Street Carrabelle FL 4 (Atlanta) 04/01/2019 Q5EJ11 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
▼ 103462 Bonifay Rural Health Clinic 2910 Hospital Drive Bonifay FL 4 (Atlanta) 08/02/2018 2D3O11 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
E0013 Development Of Ep Policies And Procedures Standard
E0036 Ep Training And Testing Standard
E0037 Ep Training Program Standard
E0039 Ep Testing Requirements Standard
J0023 Location Of Clinic Standard
J0058 Patient Care Policies Standard
J0081 Staffing And Staff Responsibilities Standard
▼ 103804 Ridge Manor Medical Clinic 34498 Cortez Blvd Ridge Manor FL 4 (Atlanta) 07/23/2025 PDWZ11 Complaint
Deficiency Tag Deficiency Description Tag Type
J0000 Initial Comments - Not A Deficiency Citation Memo
J0044 Physical Plant And Environment Standard
J0125 Provision Of Services Standard
J0153 Patient Health Records Standard
▼ 103815 Wakulla Urgent Care And Diagnostic Center Plc 41 Feli Way Crawfordville FL 4 (Atlanta) 05/26/2022 IS4511 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
J0042 Physical Plant And Environment Standard
J0123 Staffing And Staff Responsibilities Standard
J0161 Program Evaluation Standard
▼ 103834 West Florida Medical Associates Pa 213 S Pine Ave Inverness FL 4 (Atlanta) 05/19/2022 B1DI11 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
E0007 Ep Program Patient Population Standard
E0013 Development Of Ep Policies And Procedures Standard
E0023 Policies/Procedures For Medical Documentation Standard
E0024 Policies/Procedures-Volunteers And Staffing Standard
E0029 Development Of Communication Plan Standard
E0032 Primary/Alternate Means For Communication Standard
E0033 Methods For Sharing Information Standard
E0036 Ep Training And Testing Standard
E0037 Ep Training Program Standard
E0039 Ep Testing Requirements Standard
▼ 103840 Children's Medical Center 798 W Duval St Lake City FL 4 (Atlanta) 07/22/2022 B48M11 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
▼ 103846 Jack M Matheny Ii Md 700 Zeagler Drive Ste 10 Palatka FL 4 (Atlanta) 09/05/2019 K3BD11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
J0123 Staffing And Staff Responsibilities Standard
J0161 Program Evaluation Standard