S&C QCOR RHC 2567s
d QCOR: Quality, Certification and Oversight Reports. S&C QCOR  
Home  |  Help  |  Resources  |  FAQs  |  Site Map  
   
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
▼ 163833 Medical Clinic 313 Main Street Sidney IA 7 (Kansas City) 09/14/2021 4QPC11 Special, 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
J0152 Patient Health Records Standard
▼ 163833 Medical Clinic 313 Main Street Sidney IA 7 (Kansas City) 05/24/2018 591Z11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
J0021 Location Of Clinic Standard
J0023 Location Of Clinic Standard
J0057 Patient Care Policies Standard
▼ 163834 Medical Clinic 1219 Main Street Hamburg IA 7 (Kansas City) 02/22/2021 EXND11 Special, 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
E0036 Ep Training And Testing Standard
E0037 Ep Training Program Standard
J0044 Physical Plant And Environment Standard
J0101 Staffing And Staff Responsibilities Standard
J0122 Provision Of Services Standard
J0123 Staffing And Staff Responsibilities Standard
J0125 Provision Of Services Standard
J0161 Program Evaluation Standard
▼ 163836 Medical Clinic 710 Center Street Tabor IA 7 (Kansas City) 09/14/2021 CMRS11 Special, 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
▼ 163846 Kingsley Mercy Medical Clinic 111 Main Street Kingsley IA 7 (Kansas City) 09/22/2021 0LFG11 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
▼ 163846 Kingsley Mercy Medical Clinic 111 Main Street Kingsley IA 7 (Kansas City) 07/23/2019 XEMW11 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
E0029 Development Of Communication Plan Standard
E0036 Ep Training And Testing Standard
E0039 Ep Testing Requirements Standard
J0125 Provision Of Services Standard
J0152 Patient Health Records Standard
▼ 163849 Henry County Health Center-Wapello Clinic 220 Mulberry, Suite A Wapello IA 7 (Kansas City) 07/05/2023 J7LY11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
J0153 Patient Health Records Standard
▼ 163849 Henry County Health Center-Wapello Clinic 220 Mulberry, Suite A Wapello IA 7 (Kansas City) 09/16/2019 8YP311 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
E0039 Ep Testing Requirements Standard
J0043 Physical Plant And Environment Standard
J0044 Physical Plant And Environment Standard
▼ 163878 Dch Family Medicine Dallas Center 507 14th Street Dallas Center IA 7 (Kansas City) 01/14/2021 LLQR11 Special, Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
E0039 Ep Testing Requirements Standard
J0101 Staffing And Staff Responsibilities Standard
J0121 Provision Of Services Standard
J0123 Staffing And Staff Responsibilities Standard
J0153 Patient Health Records Standard
J0161 Program Evaluation Standard
▼ 163890 Family Health Care Of Siouxland 410 Main Street Moville IA 7 (Kansas City) 04/10/2019 WU7Y11 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
J0040 Physical Plant And Environment Condition
J0060 Organizational Structure Condition
J0120 Provision Of Services Condition
J0160 Program Evaluation 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
E0029 Development Of Communication Plan Standard
E0036 Ep Training And Testing Standard
E0039 Ep Testing Requirements Standard
J0042 Physical Plant And Environment Standard
J0043 Physical Plant And Environment Standard
J0044 Physical Plant And Environment Standard
J0061 Organizational Structure Standard
J0062 Organizational Structure Standard
J0101 Staffing And Staff Responsibilities Standard
J0102 Staffing And Staff Responsibilities Standard
J0123 Staffing And Staff Responsibilities Standard
J0125 Provision Of Services Standard
J0152 Patient Health Records Standard
J0153 Patient Health Records Standard
J0161 Program Evaluation Standard
J0162 Program Evaluation Standard