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 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)
K0781 Portable Space Heaters
CFR(s): NFPA 101

Portable Space Heaters Portable space heating devices shall be prohibited in all health care occupancies. Except, when used in nonsleeping staff and employee areas where the heating elements do not exceed 212 degrees Fahrenheit (100 degrees Celsius). 20.7.8, 21.7.8


This STANDARD is not met as evidenced by:
Based on observation, the facility failed to prohibit a portable space heating device per the requirements of:





2012 NFPA 101, 21.7.8





This deficiency affects 1 of 7 smoke compartments.





Findings include:





During a tour of the facility, the surveyor observed a portable space heating device that was off, sitting on a laminate floor, between a wood desk and metal desk and plugged in to a power strip. This was not located in a patient sleeping smoke compartment. The facility was unable to provide documentation that the heating element did not exceeding 212 degrees.





A member of the maintenance staff was present when this deficiency was identified.





.