S&C QCOR RHC 2567s
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RHCs 2567s
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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
▼ 253418 Itta Bena Clinic 103 Basket Street Itta Bena MS 4 (Atlanta) 01/19/2023 JBB211 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
J0125 Provision Of Services Standard
▼ 253474 Rush Central Clinic 1221 24th Avenue Meridian MS 4 (Atlanta) 10/06/2022 CI3I11 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
▼ 253481 Lucedale Ob/Gyn Center 859 Winter Street, Ste A Lucedale MS 4 (Atlanta) 08/22/2018 FCKO11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
J0059 Direct Services Standard
▼ 253487 Macon Primary Clinic 78 Hospital Road Macon MS 4 (Atlanta) 10/19/2021 IECM11 Special, Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
J0152 Patient Health Records Standard
▼ 253497 C C H Clinc Family Medical 701 Holly Avenue Collins MS 4 (Atlanta) 03/04/2021 BHC111 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
J0152 Patient Health Records Standard
▼ 253800 Gorton Rural Health Clinic, Llc 107 Church Street Belzoni MS 4 (Atlanta) 03/29/2022 YY5O11 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
J0013 Licensure/Cert/Registration Of Personnel Standard
J0044 Physical Plant And Environment Standard
J0101 Staffing And Staff Responsibilities Standard
J0153 Patient Health Records Standard
▼ 253814 L C Tennin, Jr, Md, Pa 122 East Academy Street Canton MS 4 (Atlanta) 01/24/2023 8RT511 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
J0120 Provision Of Services Condition
J0150 Patient Health Records Condition
J0160 Program Evaluation Condition
E0004 Develop Ep Plan, Review And Update Annually Standard
E0013 Development Of Ep Policies And Procedures Standard
E0029 Development Of Communication Plan Standard
E0036 Ep Training And Testing Standard
J0013 Licensure/Cert/Registration Of Personnel Standard
J0042 Physical Plant And Environment Standard
J0101 Staffing And Staff Responsibilities Standard
J0110 Covid-19 Vaccination Of Facility Staff Standard
J0123 Staffing And Staff Responsibilities Standard
J0125 Provision Of Services Standard
J0135 Provision Of Services Standard
J0140 Provision Of Services Standard
J0151 Patient Health Records Standard
J0161 Program Evaluation Standard
J0162 Program Evaluation Standard
▼ 253855 Yazoo Family Clinic 1435 Grand Avenue Yazoo City MS 4 (Atlanta) 09/05/2019 7JDG11 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
▼ 253861 Rankin Rural Medical Clinic 129 Center Street, Suite B Richland MS 4 (Atlanta) 07/29/2019 P9QG11 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
J0160 Program Evaluation Condition
▼ 253901 Ems Clinic 1604-B Leflore Avenue Greenwood MS 4 (Atlanta) 04/19/2018 294Q11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
J0000 Initial Comments - Not A Deficiency Citation Memo
J0076 Program Evaluation Condition
E0006 Plan Based On All Hazards Risk Assessment Standard
E0007 Ep Program Patient Population Standard
E0013 Development Of Ep Policies And Procedures Standard
E0036 Ep Training And Testing Standard
J0047 Physician Responsibilities Standard
J0051 Physician Assistant/Nurse Practitioner Responsibilities Standard
J0057 Patient Care Policies Standard
J0077 Annual Total Program Evaluation Standard
J0086 Staffing And Staff Responsibilities Standard