S&C QCOR RHC 2567s
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RHCs 2567s
Selection Criteria ▸

Time Interval

Please select the calendar year or years for which you would like data.

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
▼ 163477 Chi Health Clinic Woodbine 518 Lincoln Way Woodbine IA 7 (Kansas City) 02/15/2023 HCCW11 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
J0151 Patient Health Records Standard
▼ 163477 Chi Health Clinic Woodbine 518 Lincoln Way Woodbine IA 7 (Kansas City) 09/25/2019 6TJE11 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
J0043 Physical Plant And Environment Standard
J0136 Provision Of Services Standard
J0161 Program Evaluation Standard
▼ 163478 Chi Health Clinic Lenox 210 South Main Lenox IA 7 (Kansas City) 04/10/2023 OUS611 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
▼ 163478 Chi Health Clinic Lenox 210 South Main Lenox IA 7 (Kansas City) 09/12/2019 JD3011 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
J0160 Program Evaluation Condition
E0007 Ep Program Patient Population Standard
E0020 Policies For Evac. And Primary/Alt. Comm. Standard
E0022 Policies/Procedures For Sheltering In Place Standard
E0039 Ep Testing Requirements Standard
J0042 Physical Plant And Environment Standard
J0101 Staffing And Staff Responsibilities Standard
J0123 Staffing And Staff Responsibilities Standard
J0136 Provision Of Services Standard
J0161 Program Evaluation Standard
J0162 Program Evaluation Standard
▼ 163479 Chi Health Clinic Bedford 1502 Madison Street Bedford IA 7 (Kansas City) 10/02/2019 PM8511 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
J0152 Patient Health Records Standard
▼ 163480 Chi Health Clinic Corning 601 Rosary Drive Corning IA 7 (Kansas City) 02/24/2021 QHT611 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
J0123 Staffing And Staff Responsibilities Standard
▼ 163482 Family Practice Clinic Emmetsburg 3201 First Street Emmetsburg IA 7 (Kansas City) 09/01/2021 TI9F11 Special, Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
E0007 Ep Program Patient Population Standard
E0023 Policies/Procedures For Medical Documentation Standard
J0042 Physical Plant And Environment Standard
▼ 163483 Burgess Family Clinic - Sloan 409 Evans St Sloan IA 7 (Kansas City) 12/24/2024 0ISD11 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
▼ 163483 Burgess Family Clinic - Sloan 409 Evans St Sloan IA 7 (Kansas City) 07/21/2021 GNSJ11 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
J0044 Physical Plant And Environment Standard
▼ 163485 Urbana Family Medical Clinic 1002 West Main Street Urbana IA 7 (Kansas City) 02/04/2021 H2XE11 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
J0122 Provision Of Services Standard
J0123 Staffing And Staff Responsibilities Standard
J0125 Provision Of Services Standard
J0153 Patient Health Records Standard