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
▼ 143485 Carle Cissna Park 141 West Garfield Avenue Cissna Park IL 5 (Chicago) 01/10/2019 Q3BB11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
J0085 Staffing And Staff Responsibilities Standard
J0123 Staffing And Staff Responsibilities Standard
▼ 143487 Louisiville Medical Clinic 935 Bryant Street Louisville IL 5 (Chicago) 10/10/2018 C2D511 Standard
Deficiency Tag Deficiency Description Tag Type
J0000 Initial Comments - Not A Deficiency Citation Memo
J0023 Location Of Clinic Standard
J0055 Patient Care Policies Standard
▼ 143492 Graham Medical Group Canton 180s Main St Canton IL 5 (Chicago) 01/27/2021 2HUO11 Special, 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
▼ 143493 Graham Medical Center - Lewiston 408 South Main Lewistown IL 5 (Chicago) 01/03/2020 K7Q611 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
E0034 Information On Occupancy/Needs Standard
J0101 Staffing And Staff Responsibilities Standard
J0124 Provision Of Services Standard
J0152 Patient Health Records Standard
J0161 Program Evaluation Standard
▼ 143496 Carle Rossville 619 N Chicago Street Rossville IL 5 (Chicago) 07/01/2022 JU5L11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
J0125 Provision Of Services Standard
▼ 143499 Lawrence County Memorial Hospital Primary Care Cli 2111 Lexington Avenue Lawrenceville IL 5 (Chicago) 12/20/2021 DNVL11 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
E0020 Policies For Evac. And Primary/Alt. Comm. Standard
E0022 Policies/Procedures For Sheltering In Place 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
E0034 Information On Occupancy/Needs Standard
E0036 Ep Training And Testing Standard
E0037 Ep Training Program Standard
E0039 Ep Testing Requirements Standard
J0125 Provision Of Services Standard
▼ 143821 Center For Medical Arts Rural Health 2601 W Main Street Carbondale IL 5 (Chicago) 02/19/2020 GEKY11 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
▼ 143822 Litchfield Family Practice Ctr 1285 Franciscan Drive Litchfield IL 5 (Chicago) 10/06/2022 GH0411 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
J0125 Provision Of Services Standard
▼ 143847 Rural Health Clinic Of Moultrie County Llc 2 West Admas Sullivan IL 5 (Chicago) 01/19/2021 4IIV11 Special, 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
J0042 Physical Plant And Environment Standard
▼ 143850 Springfield Clinic Taylorville Rural Health 600 N Main St Taylorville IL 5 (Chicago) 03/04/2021 S5YF11 Special, Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
J0125 Provision Of Services Standard