| Statement of Deficiencies | (X1) Provider/Supplier/CLIA Identification Number 01C0001010 | (X3) Date Survey Completed 01/03/2024 |
| Name of Provider or Supplier The Southern Alabama Surgery Center, Llc | Street Address, City, State 2800 Ross Clark Circle, Suite 3, Dothan, 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) |
| K0321 | Hazardous Areas - Enclosure CFR(s): NFPA 101 Hazardous Areas - Enclosure Hazardous areas must meet one of the following: *Contain 1 hour rated enclosure when non-sprinklered *Sprinkler protected with smoke resistive separation *Severe Hazard locations contain sprinkler protection and 1 hour separation with 3/4 hour rated self-closing doors 20.3.2, 21.3.2, 38.3.2, 38.3.2.2, 39.3.2.1, 39.3.2.2, 8.7 This STANDARD is not met as evidenced by: Based on observation, the facility failed to maintain a hazardous room per the requirements of: 2012 NFPA 101, 21.3.2, 39.3.2.1 and 8.7 This deficiency affects one hazardous room. Findings include: During a tour of the facility, the surveyor observed an unsealed penetration of a 2" conduit used as a chase for multiple gray, yellow, orange and blue cables on both sides of the 1 hour rated wall between the Medical Gas Storage Room and the Employee Back Hall. A member of maintenance staff was present when this deficiency was identified. . |