| Statement of Deficiencies | (X1) Provider/Supplier/CLIA Identification Number 01C0001000 | (X3) Date Survey Completed 11/14/2023 |
| 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) |
| K0908 | Gas and Vacuum Piped Systems – Central Supply System Alarms CFR(s): NFPA 101 Gas and Vacuum Piped Systems - Inspection and Testing Operations The gas and vacuum systems are inspected and tested as part of a maintenance program and include the required elements. Records of the inspections and testing are maintained as required. 5.1.14.2.3, B.5.2, 5.2.13, 5.3.13, 5.3.13.4 (NFPA 99) This STANDARD is not met as evidenced by: . Based on review of documentation, the facility failed to maintain the piped medical gas and vacuum systems per the requirements of: 2012 NFPA 99, 5.1.14.2.3 This deficiency affects all of the medical gas and vacuum systems. During a tour of the facility, the facility failed to provide documentation of the annual inspection for the piped medical gas and vacuum systems for the past 12 months. A member of the maintenance staff was present when this deficiency was identified. |