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
▼ 143949 Physicians Rural Health Clinic 3307 Broadway Suite 130 Mount Vernon IL 5 (Chicago) 12/26/2018 FTKZ11 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
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
E0042 Integrated Ep Program Standard
J0042 Physical Plant And Environment Standard
J0123 Staffing And Staff Responsibilities Standard
J0136 Provision Of Services Standard
J0161 Program Evaluation Standard
J0162 Program Evaluation Standard
▼ 143975 Deaconess Illinois Union County Family Clinic 517 N Main Street Anna IL 5 (Chicago) 11/22/2021 J3O111 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
▼ 143976 Pembroke Community Health Clinic 3400 S Main Street Hopkins Park IL 5 (Chicago) 09/15/2020 61F811 Special, 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
▼ 143981 Morrison Comm Hosp Family Care 303 N Jackson St Morrison IL 5 (Chicago) 03/08/2019 1WC611 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
J0152 Patient Health Records Standard
▼ 143987 Horizon Health Paris Clinic 727 E Court Paris IL 5 (Chicago) 02/09/2018 KH4F12 Standard
Deficiency Tag Deficiency Description Tag Type
J0076 Program Evaluation Condition
J0080 Staffing And Staff Responsibilities Condition
J0022 Location Of Clinic Standard
J0077 Annual Total Program Evaluation Standard
J0078 Evaluation Review Criteria Standard
J0079 Evaluation Review Criteria Standard
J0081 Staffing And Staff Responsibilities Standard
J0082 Staffing And Staff Responsibilities 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
▼ 143989 Chrisman Clinic 112 West Madison Avenue Chrisman IL 5 (Chicago) 01/12/2021 TCSV11 Special, Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
J0100 Staffing And Staff Responsibilities Standard
▼ 148501 Wabash General Convenient Care 1418 College Drive Mount Carmel IL 5 (Chicago) 10/04/2022 UUGZ11 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
▼ 148503 Clinton County Rural Health 9401 Holy Cross Lane Breese IL 5 (Chicago) 02/20/2019 UZ0H11 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
▼ 148504 Marshall Browing Hospital Association 900 North Washington Du Quoin IL 5 (Chicago) 04/03/2026 HJ5E11 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
▼ 148504 Marshall Browing Hospital Association 900 North Washington Du Quoin IL 5 (Chicago) 08/14/2019 XWW511 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
E0031 Emergency Officials Contact Information Standard
E0033 Methods For Sharing Information Standard
E0037 Ep Training Program Standard
J0043 Physical Plant And Environment Standard