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
▼ 10C0001289 C-Med Ambulatory Surgery Center, Inc 2238 Drew St Clearwater FL 4 (Atlanta) 08/18/2021 4Q8K21 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
E0037 EP Training Program Standard
E0039 EP Testing Requirements Standard
K0211 Means of Egress - General Standard
K0291 Emergency Lighting Standard
K0293 Exit Signage Standard
K0521 HVAC Standard
▼ 10C0001291 Lecanto Surgery Center 3075 W Gulf To Lake Hwy Lecanto FL 4 (Atlanta) 03/21/2022 P3S321 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
K0913 Electrical Systems - Wet Procedure Locations Standard
K0924 Electrical Equipment ? Wet Procedure Locations Standard
▼ 10C0001293 Winter Haven Ambulatory Surgical Center Llc 325 Avenue B Nw Winter Haven FL 4 (Atlanta) 01/14/2025 64EDD-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0181 ADMINISTRATION OF DRUGS Standard
▼ 10C0001293 Winter Haven Ambulatory Surgical Center Llc 325 Avenue B Nw Winter Haven FL 4 (Atlanta) 01/13/2025 64EDD-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
K0291 Emergency Lighting Standard
K0902 Gas and Vacuum Piped Systems - Other Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 10C0001294 Interventional Rehabilitation Center 1549 Airport Blvd Pensacola FL 4 (Atlanta) 02/24/2021 9S5Y11 Focused Infection Control, Other-Fed
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0242 INFECTION CONTROL PROGRAM Standard
▼ 10C0001294 Interventional Rehabilitation Center 1549 Airport Blvd Pensacola FL 4 (Atlanta) 02/24/2021 PQYV11 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0041 CONTRACT SERVICES Standard
Q0201 LABORATORY SERVICES Standard
Q0204 RADIOLOGIC SERVICES Standard
▼ 10C0001294 Interventional Rehabilitation Center 1549 Airport Blvd Pensacola FL 4 (Atlanta) 02/23/2021 PQYV21 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
E0006 Plan Based on All Hazards Risk Assessment Standard
E0013 Development of EP Policies and Procedures Standard
E0023 Policies/Procedures for Medical Documentation Standard
E0026 Roles Under a Waiver Declared by Secretary Standard
E0030 Names and Contact Information Standard
E0033 Methods for Sharing Information Standard
E0036 EP Training and Testing Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0372 Subdivision of Building Spaces ? Smoke Barrier Construction Standard
K0761 Maintenance, Inspection & Testing - Doors Standard
K0914 Electrical Systems - Maintenance and Testing Standard
K0921 Electrical Equipment ? Testing and Maintenance Requirements Standard
▼ 10C0001297 Physicians Day Surgery Center, Inc 850 111th Ave N Naples FL 4 (Atlanta) 12/20/2019 SNQQ11 Complaint
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0082 PROGRAM DATA; PROGRAM ACTIVITIES Standard
Q0225 SUBMISSION AND INVESTIGATION OF GRIEVANCES Standard
▼ 10C0001299 Pshs Alpha Partners Llc 7408 Lake Worth Road Lake Worth FL 4 (Atlanta) 01/19/2023 5E837-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
K0355 Portable Fire Extinguishers Standard
▼ 10C0001299 Pshs Alpha Partners Llc 7408 Lake Worth Road Lake Worth FL 4 (Atlanta) 01/18/2023 5E837-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0162 FORM AND CONTENT OF RECORD Standard