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
▼ 163453 Keosauqua Medical Clinic 304 Franklin St Keosauqua IA 7 (Kansas City) 08/16/2023 V6VY11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
E0037 Ep Training Program Standard
J0043 Physical Plant And Environment Standard
▼ 163453 Keosauqua Medical Clinic 304 Franklin St Keosauqua IA 7 (Kansas City) 09/17/2019 UQED11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
J0120 Provision Of Services Condition
E0009 Local, State, Tribal Collaboration Process Standard
E0024 Policies/Procedures-Volunteers And Staffing Standard
E0037 Ep Training Program Standard
J0043 Physical Plant And Environment Standard
J0044 Physical Plant And Environment Standard
J0136 Provision Of Services Standard
J0152 Patient Health Records Standard
▼ 163454 Osage Clinic 620 North Eighth Street Osage IA 7 (Kansas City) 09/24/2019 X6RW11 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
▼ 163455 Sully Family Health Center 704 Third Street Sully IA 7 (Kansas City) 09/19/2019 ELBF11 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
E0037 Ep Training Program Standard
J0135 Provision Of Services Standard
J0161 Program Evaluation Standard
▼ 163456 Mosaic Family Care - Bedford 408 Dodge Street Bedford IA 7 (Kansas City) 09/11/2019 HE7011 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
E0020 Policies For Evac. And Primary/Alt. Comm. Standard
E0036 Ep Training And Testing Standard
J0100 Staffing And Staff Responsibilities Standard
▼ 163461 Vinton Family Medical Clinic 504 North Ninth Avenue Vinton IA 7 (Kansas City) 01/21/2021 DLXO11 Special, Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
E0036 Ep Training And Testing Standard
E0037 Ep Training Program Standard
J0043 Physical Plant And Environment Standard
▼ 163462 Mill Creek Family Practice 5616 460th Street Paullina IA 7 (Kansas City) 09/14/2021 3SSI11 Special, 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
▼ 163462 Mill Creek Family Practice 5616 460th Street Paullina IA 7 (Kansas City) 07/10/2019 O0U311 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
E0036 Ep Training And Testing Standard
J0044 Physical Plant And Environment Standard
J0125 Provision Of Services Standard
▼ 163463 Franklin Medical Center-Latimer 101 North Akir Street Latimer IA 7 (Kansas City) 07/06/2022 RUXR11 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
E0037 Ep Training Program Standard
E0039 Ep Testing Requirements Standard
J0043 Physical Plant And Environment Standard
J0152 Patient Health Records Standard
J0161 Program Evaluation Standard
▼ 163463 Franklin Medical Center-Latimer 101 North Akir Street Latimer IA 7 (Kansas City) 09/03/2019 PBXD11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
E0036 Ep Training And Testing Standard
J0100 Staffing And Staff Responsibilities Standard
J0136 Provision Of Services Standard
J0152 Patient Health Records Standard