S&C QCOR ASC 2567s
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ASCs 2567s
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Time Interval

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Provider Characteristics

Use these filters if you want to limit the report to providers that have certain characteristics. To select more than one option, hold down the Ctrl (individual point-and-click) OR Shift keys (select through a range) while you click on the additional desired option(s).

Survey Type & Deficiency Tags

Use these filters if you want to limit the reports to providers on specific survey types, or to reports that were cited for specific ASC deficiency tags and tag types. To select more than one option, hold down the Ctrl (individual point-and-click) OR Shift keys (select through a range) while you click on the additional desired option(s).

CCN and Facility Name

Use these filters if you know the name (or partial name) of the facility you are searching for, or the CMS Certification Number (CCN) for the facility you are searching for.

Other Survey Characteristics

Select one of the options below to filter by surveys that cite deficiencies or by surveys that are deficiency-free. By default, only surveys that cite deficiencies are displayed. Selecting "All" displays all surveys.

CMS Certification Number Facility Name Address City State CMS Region Date of CMS Survey Survey Event ID Survey Type Statement of Deficiencies Report
▼ 10C0001002 Ambulatory Surgery Center Group Ltd 4500 E Fletcher Ave Tampa FL 4 (Atlanta) 03/31/2023 5EF55-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
E0026 Roles Under a Waiver Declared by Secretary Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0761 Maintenance, Inspection & Testing - Doors Standard
▼ 10C0001002 Ambulatory Surgery Center Group Ltd 4500 E Fletcher Ave Tampa FL 4 (Atlanta) 02/01/2018 FIWD21 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
K0345 Fire Alarm System - Testing and Maintenance Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0913 Electrical Systems - Wet Procedure Locations Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 10C0001002 Ambulatory Surgery Center Group Ltd 4500 E Fletcher Ave Tampa FL 4 (Atlanta) 01/31/2018 FIWD11 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0241 SANITARY ENVIRONMENT Standard
Q0243 INFECTION CONTROL PROGRAM - DIRECTION Standard
Q0261 ADMISSION ASSESSMENT Standard
Q0267 DISCHARGE WITH RESPONSIBLE ADULT Standard
▼ 10C0001003 West Florida Surgery Center Inc 5817 21st Ave W Bradenton FL 4 (Atlanta) 07/26/2022 4EEF6-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0160 MEDICAL RECORDS Condition
Q0240 INFECTION CONTROL Condition
Q0064 STANDARD LEVEL TAG FOR SURGICAL SERVICES Standard
Q0162 FORM AND CONTENT OF RECORD Standard
Q0221 NOTICE OF RIGHTS Standard
Q0223 NOTICE - PHYSICIAN OWNERSHIP Standard
Q0229 EXERCISE OF RIGHTS - INFORMED CONSENT Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0242 INFECTION CONTROL PROGRAM Standard
Q0244 INFECTION CONTROL PROGRAM - QAPI Standard
Q0245 INFECTION CONTROL PROGRAM Standard
Q0266 DISCHARGE - ORDER Standard
▼ 10C0001005 Central Fl Cataract & Laser Surg Ctr 801 N Stone St Deland FL 4 (Atlanta) 05/12/2025 65C7C-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
E0004 Develop EP Plan, Review and Update Annually Standard
K0291 Emergency Lighting Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0712 Fire Drills Standard
K0908 Gas and Vacuum Piped Systems ? Central Supply System Alarms Standard
K0914 Electrical Systems - Maintenance and Testing Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
K0923 Electrical Equipment ? Ground-Fault Circuit-Interrupter Protection Standard
K0926 Gas Equipment - Qualifications and Training Standard
▼ 10C0001005 Central Fl Cataract & Laser Surg Ctr 801 N Stone St Deland FL 4 (Atlanta) 04/04/2018 PCLE11 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0081 PROGRAM SCOPE; PROGRAM ACTIVITIES Standard
Q0084 GOVERNING BODY RESPONSIBILITIES Standard
Q0105 EMERGENCY EQUIPMENT Standard
Q0122 REAPPRAISALS Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0241 SANITARY ENVIRONMENT Standard
▼ 10C0001005 Central Fl Cataract & Laser Surg Ctr 801 N Stone St Deland FL 4 (Atlanta) 04/04/2018 PCLE21 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
E0009 Local, State, Tribal Collaboration Process Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
K0920 Electrical Equipment ? Power Cords and Extension Cords Standard
▼ 10C0001006 Belleair Surgery Center Ltd 1130 Ponce De Leon Blvd Clearwater FL 4 (Atlanta) 05/16/2018 PMW511 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0240 INFECTION CONTROL Condition
Q0162 FORM AND CONTENT OF RECORD Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0242 INFECTION CONTROL PROGRAM Standard
Q0261 ADMISSION ASSESSMENT Standard
▼ 10C0001006 Belleair Surgery Center Ltd 1130 Ponce De Leon Blvd Clearwater FL 4 (Atlanta) 05/15/2018 PMW521 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
E0007 EP Program Patient Population Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
▼ 10C0001008 Physicians Surgery Center, Llc 4035 Evans Ave Fort Myers FL 4 (Atlanta) 06/16/2026 23454B-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0241 SANITARY ENVIRONMENT Standard