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
▼ 193997 Hackberry Rural Health Clinic 1020 Main Street Hackberry LA 6 (Dallas) 05/17/2023 V3IV11 Standard
Deficiency Tag Deficiency Description Tag Type
J0000 Initial Comments - Not A Deficiency Citation Memo
J0044 Physical Plant And Environment Standard
▼ 193999 Lake Providence Medical Clinic 319 North Hood Lake Providence LA 6 (Dallas) 10/20/2021 ZF4U11 Special, Standard
Deficiency Tag Deficiency Description Tag Type
J0000 Initial Comments - Not A Deficiency Citation Memo
J0044 Physical Plant And Environment Standard
▼ 198508 Butler-Abshire Medical Clinic 926 Frances Drive Haynesville LA 6 (Dallas) 01/27/2020 3E5811 Standard
Deficiency Tag Deficiency Description Tag Type
J0000 Initial Comments - Not A Deficiency Citation Memo
J0044 Physical Plant And Environment Standard
J0152 Patient Health Records Standard
▼ 198510 Mamou Family Care 704 Poinciana Avenue Mamou LA 6 (Dallas) 12/06/2021 CY4211 Standard
Deficiency Tag Deficiency Description Tag Type
J0000 Initial Comments - Not A Deficiency Citation Memo
J0043 Physical Plant And Environment Standard
▼ 198511 Ville Platte Family Care 1013 W Lincoln Rd Ville Platte LA 6 (Dallas) 11/17/2021 NQJT11 Standard
Deficiency Tag Deficiency Description Tag Type
J0000 Initial Comments - Not A Deficiency Citation Memo
J0043 Physical Plant And Environment Standard
J0152 Patient Health Records Standard
▼ 198513 Benton Medical 188 Burt Boulevard Benton LA 6 (Dallas) 11/06/2019 BWI911 Standard
Deficiency Tag Deficiency Description Tag Type
J0000 Initial Comments - Not A Deficiency Citation Memo
J0043 Physical Plant And Environment Standard
J0152 Patient Health Records Standard
▼ 198519 Marksville Family Care Center 5541 Hwy 1 Marksville LA 6 (Dallas) 02/27/2018 5F0V11 Standard
Deficiency Tag Deficiency Description Tag Type
J0000 Initial Comments - Not A Deficiency Citation Memo
J0022 Location Of Clinic Standard
J0023 Location Of Clinic Standard
▼ 198533 Gardiner Center Health Clinic 710 5th Street Gueydan LA 6 (Dallas) 07/24/2018 IU0I11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
J0052 Provision of Services Condition
J0076 Program Evaluation Condition
J0080 Staffing And Staff Responsibilities Condition
E0037 Ep Training Program Standard
J0024 Location Of Clinic Standard
J0055 Patient Care Policies Standard
J0057 Patient Care Policies Standard
J0061 Organizational Structure Standard
J0062 Organizational Structure Standard
J0072 Protection of Record Information Standard
J0077 Annual Total Program Evaluation Standard
J0079 Evaluation Review Criteria Standard
J0081 Staffing And Staff Responsibilities Standard
▼ 203881 Family Medicine 6 Factory Rd East Machias ME 1 (Boston) 02/05/2020 03JR11 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
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
E0022 Policies/Procedures For Sheltering In Place Standard
E0023 Policies/Procedures For Medical Documentation Standard
E0029 Development Of Communication Plan Standard
E0030 Names And Contact Information Standard
E0031 Emergency Officials Contact Information Standard
E0032 Primary/Alternate Means For Communication Standard
E0033 Methods For Sharing Information Standard
E0034 Information On Occupancy/Needs Standard
E0036 Ep Training And Testing Standard
E0037 Ep Training Program Standard
E0039 Ep Testing Requirements Standard
J0082 Staffing And Staff Responsibilities Standard
J0086 Staffing And Staff Responsibilities Standard
▼ 208502 Acadia Internal Medicine & Fp 460 Main Street Suite 201 Madawaska ME 1 (Boston) 06/15/2021 E56E11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
J0062 Organizational Structure Standard