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

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Provider Characteristics

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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
▼ 10C0001416 Eye Surgery Center Of St. Augustine, Inc. 1400 Us Highway 1 South Saint Augustine FL 4 (Atlanta) 09/24/2020 982421 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
E0022 Policies/Procedures for Sheltering in Place Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0026 Roles Under a Waiver Declared by Secretary Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0712 Fire Drills Standard
K0761 Maintenance, Inspection & Testing - Doors Standard
K0914 Electrical Systems - Maintenance and Testing Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 10C0001418 Surgery Center At Jensen Beach, Llc 3995 Nw Goldenrod Rd Jensen Beach FL 4 (Atlanta) 12/13/2022 5E43A-L1 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
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 10C0001418 Surgery Center At Jensen Beach, Llc 3995 Nw Goldenrod Rd Jensen Beach FL 4 (Atlanta) 12/09/2022 5E43A-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0062 ANESTHETIC - DISCHARGE Standard
Q0162 FORM AND CONTENT OF RECORD Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0243 INFECTION CONTROL PROGRAM - DIRECTION Standard
Q0266 DISCHARGE - ORDER Standard
▼ 10C0001419 Rmg Ivf/Surgery Center Llc 5249 E Fletcher Ave Tampa FL 4 (Atlanta) 05/09/2023 4F24A-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0081 PROGRAM SCOPE; PROGRAM ACTIVITIES Standard
▼ 10C0001419 Rmg Ivf/Surgery Center Llc 5249 E Fletcher Ave Tampa FL 4 (Atlanta) 04/06/2023 5F6FB-L1 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
K0521 HVAC Standard
K0914 Electrical Systems - Maintenance and Testing Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 10C0001420 Health Boulevard Surgical Center, Llc 549 Health Blvd Daytona Beach FL 4 (Atlanta) 09/23/2025 66471-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
E0006 Plan Based on All Hazards Risk Assessment Standard
E0009 Local, State, Tribal Collaboration Process Standard
E0013 Development of EP Policies and Procedures Standard
E0023 Policies/Procedures for Medical Documentation Standard
E0030 Names and Contact Information Standard
E0036 EP Training and Testing Standard
E0037 EP Training Program Standard
E0039 EP Testing Requirements Standard
E0042 Integrated EP Program Standard
K0291 Emergency Lighting Standard
K0711 Evacuation and Relocation Plan Standard
K0712 Fire Drills Standard
K0761 Maintenance, Inspection & Testing - Doors Standard
K0901 Fundamentals - Building System Categories Standard
K0913 Electrical Systems - Wet Procedure Locations Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
K0926 Gas Equipment - Qualifications and Training Standard
K0933 Features of Fire Protection ? Fire Loss Prevention Standard
▼ 10C0001420 Health Boulevard Surgical Center, Llc 549 Health Blvd Daytona Beach FL 4 (Atlanta) 09/24/2019 2S3721 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
E0006 Plan Based on All Hazards Risk Assessment Standard
E0009 Local, State, Tribal Collaboration Process Standard
E0022 Policies/Procedures for Sheltering in Place Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0026 Roles Under a Waiver Declared by Secretary Standard
E0032 Primary/Alternate Means for Communication Standard
E0033 Methods for Sharing Information Standard
E0034 Information on Occupancy/Needs Standard
▼ 10C0001422 Advanced Eye Surgery Center 3500 Us Highway 1 Vero Beach FL 4 (Atlanta) 03/02/2023 5EFE2-H1 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
Q0262 ADMISSION AND PRE-SURGICAL ASSESSMENT Standard
Q0264 POST-SURGICAL ASSESSMENT Standard
▼ 10C0001422 Advanced Eye Surgery Center 3500 Us Highway 1 Vero Beach FL 4 (Atlanta) 02/07/2018 52B621 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
E0006 Plan Based on All Hazards Risk Assessment Standard
E0013 Development of EP Policies and Procedures Standard
K0353 Sprinkler System - Maintenance and Testing Standard
▼ 10C0001423 Advanced Surgery Center, Inc 10900 Se 174th Place Summerfield FL 4 (Atlanta) 08/16/2023 6061A-L1 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
K0355 Portable Fire Extinguishers Standard