S&C QCOR RHC 2567s
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RHCs 2567s
Selection Criteria ▸

Time Interval

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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
▼ 168576 Adair County Medical Clinic Stuart 303 Sw 7th Street, Suite B Stuart IA 7 (Kansas City) 01/29/2019 KGCW11 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
E0007 Ep Program Patient Population Standard
J0044 Physical Plant And Environment Standard
J0101 Staffing And Staff Responsibilities Standard
J0161 Program Evaluation Standard
▼ 168577 Burgess Clinic Whiting 153 Blair Street Whiting IA 7 (Kansas City) 04/06/2022 6Y8611 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
J0136 Provision Of Services Standard
J0161 Program Evaluation Standard
J0162 Program Evaluation Standard
▼ 168579 Unitypoint Health-Family Medicine Clinic-Conrad 105 N Church Street Conrad IA 7 (Kansas City) 01/31/2024 S9YM11 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
J0135 Provision Of Services Standard
▼ 168579 Unitypoint Health-Family Medicine Clinic-Conrad 105 N Church Street Conrad IA 7 (Kansas City) 12/09/2019 JVS911 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
E0022 Policies/Procedures For Sheltering In Place Standard
J0101 Staffing And Staff Responsibilities Standard
J0136 Provision Of Services Standard
J0152 Patient Health Records Standard
J0161 Program Evaluation Standard
▼ 168580 Unitypoint Health-Family Medicine Clinic-State Ctr 503 3rd Avenue Sw State Center IA 7 (Kansas City) 08/25/2025 4NFB11 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
▼ 168581 Unitypoint Health-Marshalltown-Tama-Toledo Clinic 1307 S Broadway Street, Upper Level Toledo IA 7 (Kansas City) 10/02/2019 8AT811 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
▼ 168582 Gundersen Palmer Lutheran Hosp & Clin-West Union 110 Jefferson Street West Union IA 7 (Kansas City) 09/23/2019 0K0L11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
E0037 Ep Training Program Standard
J0043 Physical Plant And Environment Standard
J0044 Physical Plant And Environment Standard
J0100 Staffing And Staff Responsibilities Standard
▼ 168583 Gundersen Palmer Lutheran Hosp & Clin - Postville 111 South Reynolds Postville IA 7 (Kansas City) 09/16/2021 Z6ZV11 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
J0043 Physical Plant And Environment Standard
▼ 168584 Gundersen Palmer Lutheran Hosp & Clinics-Fayette 110 King Street Fayette IA 7 (Kansas City) 10/25/2022 S6ZK11 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
▼ 168584 Gundersen Palmer Lutheran Hosp & Clinics-Fayette 110 King Street Fayette IA 7 (Kansas City) 09/17/2019 D4EF11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
J0120 Provision Of Services Condition
J0100 Staffing And Staff Responsibilities Standard
J0136 Provision Of Services Standard