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
▼ 103847 The Health Clinic Llc 1351 South Blvd Chipley FL 4 (Atlanta) 08/02/2018 7YUN11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
J0076 Program Evaluation Condition
J0080 Staffing And Staff Responsibilities Condition
J0077 Annual Total Program Evaluation Standard
J0079 Evaluation Review Criteria Standard
J0083 Staffing And Staff Responsibilities Standard
J0084 Staffing And Staff Responsibilities Standard
J0085 Staffing And Staff Responsibilities Standard
J0086 Staffing And Staff Responsibilities Standard
▼ 103851 Heartland Pediatric Association Of Wauchula 120 Heartland Way Wauchula FL 4 (Atlanta) 08/02/2018 09AF11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
J0076 Program Evaluation Condition
J0032 Basic Requirements Standard
J0058 Patient Care Policies Standard
J0077 Annual Total Program Evaluation Standard
▼ 103857 Family Medical Group Pa 113 Health Way Lake Placid FL 4 (Atlanta) 06/05/2019 FE0511 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
J0082 Staffing And Staff Responsibilities Standard
▼ 103858 Jay Medical Center 14088 Alabama Street Jay FL 4 (Atlanta) 06/10/2019 CH1X11 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
▼ 103881 Premier Pediatrics Llc 7960 Sw 60th Ave Ocala FL 4 (Atlanta) 08/02/2023 35LH11 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
▼ 103884 Family Medical Group Pa 3420 Us 27 N Sebring FL 4 (Atlanta) 07/19/2021 7QUM11 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
▼ 103902 Childrens Clinic 1100 N Main St Belle Glade FL 4 (Atlanta) 12/17/2019 GLUI11 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
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
E0029 Development Of Communication Plan Standard
E0037 Ep Training Program Standard
E0039 Ep Testing Requirements Standard
J0043 Physical Plant And Environment Standard
J0151 Patient Health Records Standard
▼ 103905 Avon Medical Center 1221 W Stratford Rd Avon Park FL 4 (Atlanta) 07/31/2018 OEQ611 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
J0076 Program Evaluation Condition
J0023 Location Of Clinic Standard
J0024 Location Of Clinic Standard
J0062 Organizational Structure Standard
J0079 Evaluation Review Criteria Standard
J0084 Staffing And Staff Responsibilities Standard
J0086 Staffing And Staff Responsibilities Standard
▼ 103918 Ahmad Tariq Ismail 110 East Byrd Street Bonifay FL 4 (Atlanta) 07/31/2018 SJF511 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
J0019 Physical Plant And Environment Condition
J0076 Program Evaluation Condition
J0080 Staffing And Staff Responsibilities 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
E0023 Policies/Procedures For Medical Documentation Standard
E0029 Development Of Communication Plan Standard
E0031 Emergency Officials Contact Information 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
J0021 Location Of Clinic Standard
J0022 Location Of Clinic Standard
J0023 Location Of Clinic Standard
J0024 Location Of Clinic Standard
J0032 Basic Requirements Standard
J0061 Organizational Structure Standard
J0062 Organizational Structure Standard
J0072 Protection of Record Information Standard
J0077 Annual Total Program Evaluation Standard
J0079 Evaluation Review Criteria Standard
J0083 Staffing And Staff Responsibilities Standard
J0084 Staffing And Staff Responsibilities Standard
J0085 Staffing And Staff Responsibilities Standard
J0086 Staffing And Staff Responsibilities Standard
▼ 103920 Bushnell Family Practice 117 W Belt Ave Bushnell FL 4 (Atlanta) 09/05/2019 3CR911 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
E0013 Development Of Ep Policies And Procedures Standard
E0020 Policies For Evac. And Primary/Alt. Comm. 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
E0031 Emergency Officials Contact Information 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