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
▼ 168948 Mercyone Buffalo Center Rural Family Medicine 115 North Main Street Buffalo Center IA 7 (Kansas City) 09/17/2019 0MK411 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
J0160 Program Evaluation Condition
J0136 Provision Of Services Standard
J0153 Patient Health Records Standard
J0161 Program Evaluation Standard
J0162 Program Evaluation Standard
▼ 168949 Mercy Care Tama 402 Siegal Street Tama IA 7 (Kansas City) 12/07/2022 XQYI11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
J0040 Physical Plant And Environment Condition
J0042 Physical Plant And Environment Standard
J0044 Physical Plant And Environment Standard
J0061 Organizational Structure Standard
J0136 Provision Of Services Standard
J0161 Program Evaluation Standard
▼ 168949 Mercy Care Tama 402 Siegal Street Tama IA 7 (Kansas City) 09/17/2019 3ML311 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
E0009 Local, State, Tribal Collaboration Process Standard
E0031 Emergency Officials Contact Information Standard
E0039 Ep Testing Requirements Standard
J0042 Physical Plant And Environment Standard
J0043 Physical Plant And Environment Standard
J0044 Physical Plant And Environment Standard
J0122 Provision Of Services Standard
J0123 Staffing And Staff Responsibilities Standard
J0125 Provision Of Services Standard
J0135 Provision Of Services Standard
▼ 168951 Henry County Health Center-Mediapolis Clinic 401 N Orchard Mediapolis IA 7 (Kansas City) 10/17/2019 WDX011 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
E0039 Ep Testing Requirements Standard
J0043 Physical Plant And Environment Standard
▼ 168953 Unitypoint Clinic-Family Medicine-Grundy Center 101 East J Avenue, Suite 120 Grundy Center IA 7 (Kansas City) 09/24/2019 W3U011 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
E0024 Policies/Procedures-Volunteers And Staffing Standard
E0039 Ep Testing Requirements Standard
J0042 Physical Plant And Environment Standard
J0123 Staffing And Staff Responsibilities Standard
J0136 Provision Of Services Standard
J0161 Program Evaluation Standard
▼ 168955 Unitypoint Clinc - Family Medicine- Rohlf Memorial 312 9th Street Sw, Suite 1200 Waverly IA 7 (Kansas City) 08/27/2019 U2EY11 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
J0043 Physical Plant And Environment Standard
J0044 Physical Plant And Environment Standard
J0136 Provision Of Services Standard
▼ 173405 Lincoln County Medical Clinic 313 E Franklin Lincoln KS 7 (Kansas City) 07/24/2025 QYG911 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
E0030 Names And Contact Information Standard
E0042 Integrated Ep Program Standard
J0043 Physical Plant And Environment Standard
▼ 173408 Sylvan Medical Clinic 219 N Main Street Sylvan Grove KS 7 (Kansas City) 07/24/2025 1KD011 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
E0022 Policies/Procedures For Sheltering In Place Standard
E0030 Names And Contact Information Standard
E0042 Integrated Ep Program Standard
▼ 173483 Centralia Medical Clinic 606 First Street Centralia KS 7 (Kansas City) 03/06/2018 EVN911 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
J0023 Location Of Clinic Standard
J0074 Protection Of Record Information Standard
▼ 173486 Onaga Clinic 114 W 8th Street Onaga KS 7 (Kansas City) 03/06/2018 99PO11 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
J0022 Location Of Clinic Standard
J0023 Location Of Clinic Standard
J0055 Patient Care Policies Standard
J0074 Protection Of Record Information Standard