| Statement of Deficiencies | (X1) Provider/Supplier/CLIA Identification Number 01C0001000 | (X3) Date Survey Completed 11/14/2019 |
| Name of Provider or Supplier Montgomery Surgical Center Llc | Street Address, City, State 470 Taylor Road, Montgomery, AL | |
| For information on the provider's plan to correct this deficiency, please contact the provider or the state survey agency. | ||
| (X4) ID Prefix Tag | Summary Statement of Deficiencies
(Each deficiency should be preceded by full regulatory or LSC identifying information) |
| K0771 | Engineer Smoke Control Systems CFR(s): NFPA 101 Engineered Smoke Control Systems When installed, engineered smoke control systems are tested in accordance with established engineering principles. Test documentation is maintained on the premises. 20.7.7.1 through 20.7.7.3, 21.7.7.1 through 21.7.7.3 This STANDARD is not met as evidenced by: . Based on review of documentation and interview, the facility failed to maintain the atrium smoke evacuation system per requirements of: 2012 NFPA 101, 21.7.7, 21.7.6, and 4.6.12 2011 NFPA 92, 8.6 This deficiency could affect approximately 20 occupants. Findings include: On 11/14/2019, during a tour of the facility from 8:00 am to 4:45 pm, the facility failed to provide documentation of the periodically testing of the smoke evacuation system in the atrium. A member of the maintenance staff was present when this deficiency was identified. . |