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
▼ 168904 Bchc Family Medicine - Oelwein 124 1st Avenue Se Oelwein IA 7 (Kansas City) 09/16/2019 7V1A11 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
E0037 Ep Training Program Standard
J0043 Physical Plant And Environment Standard
J0136 Provision Of Services Standard
▼ 168934 Mercyone Correctionville Family Medicine 1120 East Highway 20 Correctionville IA 7 (Kansas City) 08/25/2021 7B7011 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
J0161 Program Evaluation Standard
▼ 168943 Stuart Medical Clinic 106 Ne Second Street Stuart IA 7 (Kansas City) 08/29/2019 YW5911 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
J0080 Staffing And Staff Responsibilities Condition
J0120 Provision Of Services Condition
J0150 Patient Health Records 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
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
J0042 Physical Plant And Environment Standard
J0043 Physical Plant And Environment Standard
J0044 Physical Plant And Environment Standard
J0061 Organizational Structure Standard
J0081 Staffing And Staff Responsibilities Standard
J0100 Staffing And Staff Responsibilities Standard
J0102 Staffing And Staff Responsibilities Standard
J0123 Staffing And Staff Responsibilities Standard
J0125 Provision Of Services Standard
J0135 Provision Of Services Standard
J0136 Provision Of Services Standard
J0152 Patient Health Records Standard
J0153 Patient Health Records Standard
J0161 Program Evaluation Standard
J0162 Program Evaluation Standard
▼ 168945 Anthon Mercy Medical Clinic 307 Main Street Anthon IA 7 (Kansas City) 08/14/2019 JMYX11 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
J0044 Physical Plant And Environment Standard
J0125 Provision Of Services Standard
J0153 Patient Health Records Standard
J0161 Program Evaluation Standard
▼ 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
▼ 168950 Mercy Care Monticello 225 Welter Dr Monticello IA 7 (Kansas City) 04/09/2026 ZVF611 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
▼ 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