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
▼ 153860 Martin County Health Center 229 High St Shoals IN 5 (Chicago) 07/01/2025 SKSJ11 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
▼ 153860 Martin County Health Center 229 High St Shoals IN 5 (Chicago) 06/13/2019 9PYE11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
J0101 Staffing And Staff Responsibilities Standard
J0136 Provision Of Services Standard
▼ 153862 Switzerland County Nurse Managed Clinic 727 Hwy 56 Ste 300 Vevay IN 5 (Chicago) 09/22/2020 21E211 Special, Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
J0041 Physical Plant And Environment Standard
J0042 Physical Plant And Environment Standard
▼ 153864 Kenneth D Watkins Md 108 Hospital Dr Winchester IN 5 (Chicago) 06/15/2021 GMZ011 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
J0044 Physical Plant And Environment Standard
J0123 Staffing And Staff Responsibilities Standard
J0135 Provision Of Services Standard
▼ 153869 Brazil Family Medicine 115 S Murphy Avenue, Ste A Brazil IN 5 (Chicago) 08/11/2021 0MPJ11 Special, Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
E0013 Development Of Ep Policies And Procedures Standard
J0043 Physical Plant And Environment Standard
J0044 Physical Plant And Environment Standard
J0101 Staffing And Staff Responsibilities Standard
J0123 Staffing And Staff Responsibilities Standard
J0153 Patient Health Records Standard
J0161 Program Evaluation Standard
▼ 153871 Country Health Center 5066 N 900 E Montgomery IN 5 (Chicago) 06/28/2022 KONW11 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
J0152 Patient Health Records Standard
▼ 153872 Petersburg Family Medicine 1003 E Illinois St Petersburg IN 5 (Chicago) 10/23/2024 JKJ311 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
J0044 Physical Plant And Environment Standard
J0062 Organizational Structure Standard
▼ 153872 Petersburg Family Medicine 1003 E Illinois St Petersburg IN 5 (Chicago) 10/05/2018 OTCR11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
J0023 Location Of Clinic Standard
J0062 Organizational Structure Standard
J0067 Records System Standard
▼ 153881 St Vincent Medical Group, Inc 409 Greenville Ave Winchester IN 5 (Chicago) 06/14/2021 7V5V11 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
J0044 Physical Plant And Environment Standard
▼ 153882 St Luke's Medical Ministry Pc 1441 N Gardner, P O Box 677 Scottsburg IN 5 (Chicago) 08/06/2019 JXAN11 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
J0044 Physical Plant And Environment Standard
J0125 Provision Of Services Standard
J0152 Patient Health Records Standard