S&C QCOR RHC 2567s
d QCOR:  Quality, Certification and Oversight Reports.
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
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
163468 Van Horne Family Medical Clinic 205 Main Street Van Horne IA 7 (Kansas City) 05/26/2022 F6OJ11 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
163468 Van Horne Family Medical Clinic 205 Main Street Van Horne IA 7 (Kansas City) 08/19/2019 CBYJ11 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
163469 Lenox Medical Clinic 100 S Main Street Lenox IA 7 (Kansas City) 08/01/2019 TTGF11 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
J0161 Program Evaluation Standard
163470 Burgess Family Clinc - Dunlap 612 Iowa Avenue Dunlap IA 7 (Kansas City) 09/04/2019 OGQU11 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
E0004 Develop Ep Plan, Review And Update Annually Standard
E0039 Ep Testing Requirements Standard
J0043 Physical Plant And Environment Standard
J0123 Staffing And Staff Responsibilities Standard
J0161 Program Evaluation Standard
J0162 Program Evaluation Standard
163472 Family Practice Clinic Graettinger 109 West Robbins Street Graettinger IA 7 (Kansas City) 07/05/2023 UOSF11 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
J0125 Provision Of Services Standard
163472 Family Practice Clinic Graettinger 109 West Robbins Street Graettinger IA 7 (Kansas City) 09/24/2019 3RNS11 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
E0039 Ep Testing Requirements Standard
163475 Mccrary Rost Clinic 1800 Main Street Gowrie IA 7 (Kansas City) 11/15/2022 G4C111 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
J0100 Staffing And Staff Responsibilities Standard