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
▼ 163486 Earlham Medical Clinic 125 West First Street Earlham IA 7 (Kansas City) 02/18/2021 D8M211 Special, 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
J0123 Staffing And Staff Responsibilities Standard
J0161 Program Evaluation Standard
▼ 163487 Cherokee Medical Clinic 300 Sioux Valley Drive Cherokee IA 7 (Kansas City) 08/31/2021 SH0E11 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
J0161 Program Evaluation Standard
▼ 163487 Cherokee Medical Clinic 300 Sioux Valley Drive Cherokee IA 7 (Kansas City) 07/02/2019 OEL711 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
E0013 Development Of Ep Policies And Procedures Standard
E0020 Policies For Evac. And Primary/Alt. Comm. Standard
E0036 Ep Training And Testing Standard
E0039 Ep Testing Requirements Standard
J0043 Physical Plant And Environment Standard
J0125 Provision Of Services Standard
▼ 163488 Mercyone Paullina Family Medicine 108 East Groesbeck Street Paullina IA 7 (Kansas City) 02/04/2021 TWP411 Special, Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
J0136 Provision Of Services Standard
J0161 Program Evaluation Standard
▼ 163489 Mercyone Sutherland Family Medicine 131 West Second Street Sutherland IA 7 (Kansas City) 02/04/2021 XYXL11 Special, 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
▼ 163490 Mercyone Primghar Family Medicine 240 North Rerick Avenue Primghar IA 7 (Kansas City) 12/30/2020 LS0K11 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
E0020 Policies For Evac. And Primary/Alt. Comm. Standard
E0022 Policies/Procedures For Sheltering In Place Standard
J0102 Staffing And Staff Responsibilities Standard
J0125 Provision Of Services Standard
J0135 Provision Of Services Standard
J0161 Program Evaluation Standard
▼ 163492 Mercyone Hartley Family Medicine 231 North Eighth Avenue West Hartley IA 7 (Kansas City) 07/16/2019 KGCV11 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
E0006 Plan Based On All Hazards Risk Assessment Standard
E0039 Ep Testing Requirements Standard
J0044 Physical Plant And Environment Standard
J0125 Provision Of Services Standard
▼ 163493 Cresco Medical Clinic 321 Eighth Avenue West Cresco IA 7 (Kansas City) 02/25/2021 URCU11 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
▼ 163494 Lime Springs Medical Clinic 101 West Main Street Lime Springs IA 7 (Kansas City) 09/26/2019 Z1T211 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
▼ 163495 Clarion Clinic 215 13th Avenue Sw Clarion IA 7 (Kansas City) 09/05/2019 KLEX11 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
J0043 Physical Plant And Environment Standard
J0044 Physical Plant And Environment Standard
J0123 Staffing And Staff Responsibilities Standard