Department of Health & Human Services

Centers for Medicare & Medicaid Services
Form Approved

OMB No. 0938-0391

Statement of Deficiencies (X1) Provider/Supplier/CLIA Identification Number 01C0001009 (X3) Date Survey Completed 07/30/2025
Name of Provider or Supplier Surgicare Of Mobile, Ltd Street Address, City, State 2890 Dauphin St, Mobile, 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)
K0000 .

 

K3 Building: 0101
K6 Plan Approval: 1993, 08/24/2016
K7 Survey Under: 2012 Existing
K8 ASC
Generator: One Diesel, Kohler 180 kW (installed 2009 with remote manual stop station)
FACP: Simplex (installed 2016)
Smoke Detection: Partial
Locking Devices: None
Number of cases a month: 1500

 

 

Type of Structure: 1993 one story protected noncombustible, Type II(111).  2016 unprotected ordinary, Type III(200).  The facility has a complete automatic sprinkler system.

 

 

During a routine recertification survey conducted on this date, the requirements of 42 CFR, Subpart 416.44(b) was not met as evidenced by the following deficiencies of the 2012 NFPA 101 Life Safety Code (LSC), the 2012 NFPA 99 Health Care Facilities Code and the standards referenced by these codes, as observed by the LS Surveyor while accompanied by the facility maintenance personnel.

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