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
▼ 163892 Gundersen Lansing Clinic 50 North 4th Street Lansing IA 7 (Kansas City) 01/26/2021 4F4E11 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
▼ 163892 Gundersen Lansing Clinic 50 North 4th Street Lansing IA 7 (Kansas City) 04/26/2018 3N7C11 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
E0007 Ep Program Patient Population Standard
E0009 Local, State, Tribal Collaboration Process Standard
E0039 Ep Testing Requirements Standard
J0023 Location Of Clinic Standard
▼ 163976 Kossuth Regional Health Center 122 West Ramsey Street Bancroft IA 7 (Kansas City) 09/19/2019 4T3311 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
J0100 Staffing And Staff Responsibilities Standard
J0152 Patient Health Records Standard
▼ 163979 Franklin Medical Center-Dumont 606 South Second Street Dumont IA 7 (Kansas City) 07/30/2019 RDD511 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
E0009 Local, State, Tribal Collaboration Process Standard
J0042 Physical Plant And Environment Standard
J0123 Staffing And Staff Responsibilities Standard
J0136 Provision Of Services Standard
J0161 Program Evaluation Standard
▼ 163996 Fox River Medical Clinic 14983 275th Street Cantril IA 7 (Kansas City) 09/24/2019 2S5111 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
▼ 168500 Adair County Medical Clinic-Greenfield 609 Southeast Kent Greenfield IA 7 (Kansas City) 07/02/2019 Z8Z811 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
▼ 168503 Hawarden Regional Healthcare Clinics, Llc 1122 Avenue L Hawarden IA 7 (Kansas City) 09/15/2021 9TK911 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
▼ 168503 Hawarden Regional Healthcare Clinics, Llc 1122 Avenue L Hawarden IA 7 (Kansas City) 08/13/2019 3T2611 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
J0043 Physical Plant And Environment Standard
▼ 168505 Sanford Clinic Sanborn 321 Main Street Sanborn IA 7 (Kansas City) 11/25/2025 IOCQ11 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
▼ 168505 Sanford Clinic Sanborn 321 Main Street Sanborn IA 7 (Kansas City) 01/20/2021 DNFW11 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
J0044 Physical Plant And Environment Standard