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
▼ 168533 Mercyone Centerville Medical Clinic 19942 St Joseph Drive Centerville IA 7 (Kansas City) 09/23/2019 LQ3111 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
J0136 Provision Of Services Standard
J0152 Patient Health Records Standard
▼ 168536 Mch Clinic 6582 165th Street Albia IA 7 (Kansas City) 09/25/2019 15ZV11 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
J0044 Physical Plant And Environment Standard
▼ 168537 Horn Physicians Clinic 700 East 2nd Street, Suite 2 Ida Grove IA 7 (Kansas City) 07/09/2019 UCD511 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
J0043 Physical Plant And Environment Standard
J0044 Physical Plant And Environment Standard
J0102 Staffing And Staff Responsibilities Standard
J0125 Provision Of Services Standard
▼ 168538 Burgess Family Clinic - Maple Valley 513 South Muckey Street Mapleton IA 7 (Kansas City) 07/22/2021 ZY9111 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
J0101 Staffing And Staff Responsibilities Standard
J0152 Patient Health Records Standard
▼ 168539 Christophel Clinic 312 9th Street Sw, Suite 2300 Waverly IA 7 (Kansas City) 09/21/2021 GG2311 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
▼ 168540 Women's Clinic 312 9th Street Sw, Suite 2200 Waverly IA 7 (Kansas City) 08/28/2019 S8K111 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
▼ 168545 Mccrary-Rost Clinic 505 East Lake Street Rockwell City IA 7 (Kansas City) 09/24/2019 E6I911 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
E0031 Emergency Officials Contact Information Standard
E0036 Ep Training And Testing Standard
J0043 Physical Plant And Environment Standard
J0044 Physical Plant And Environment Standard
J0102 Staffing And Staff Responsibilities Standard
J0136 Provision Of Services Standard
J0153 Patient Health Records Standard
▼ 168546 Audubon Family Health Care 515 Pacific Street, Suite 2 Audubon IA 7 (Kansas City) 09/14/2021 LXY211 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
▼ 168550 Cornerstone Family Practice 101 E Watson St Garnavillo IA 7 (Kansas City) 10/11/2018 M2FE11 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
E0013 Development Of Ep Policies And Procedures Standard
J0042 Physical Plant And Environment Standard
J0044 Physical Plant And Environment Standard
J0161 Program Evaluation Standard
▼ 168552 Cornerstone Family Practice 200 Main Street Guttenberg IA 7 (Kansas City) 09/08/2021 NFFT11 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