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
▼ 10C0001505 Lake Endoscopy Center 17355 Se 109th Terrace Road Summerfield FL 4 (Atlanta) 08/19/2020 YRO511 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0141 ORGANIZATION AND STAFFING Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0241 SANITARY ENVIRONMENT Standard
▼ 10C0001507 Sand Lake Surgery Center, Llc 7477 Sand Lake Commons Blvd Orlando FL 4 (Atlanta) 06/12/2025 66377-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0181 ADMINISTRATION OF DRUGS Standard
▼ 10C0001507 Sand Lake Surgery Center, Llc 7477 Sand Lake Commons Blvd Orlando FL 4 (Atlanta) 09/14/2021 SUOE11 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0101 PHYSICAL ENVIRONMENT Standard
Q0109 EMERGENCY EQUIPMENT Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0221 NOTICE OF RIGHTS Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0245 INFECTION CONTROL PROGRAM Standard
▼ 10C0001509 Orange City Surgical Llc 1053 Medical Center Dr Orange City FL 4 (Atlanta) 02/27/2025 65040-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
▼ 10C0001509 Orange City Surgical Llc 1053 Medical Center Dr Orange City FL 4 (Atlanta) 07/17/2020 MNNO11 Focused Infection Control, Other-Fed, Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0141 ORGANIZATION AND STAFFING Standard
Q0162 FORM AND CONTENT OF RECORD Standard
▼ 10C0001509 Orange City Surgical Llc 1053 Medical Center Dr Orange City FL 4 (Atlanta) 07/16/2020 MNNO21 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
E0033 Methods for Sharing Information Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0902 Gas and Vacuum Piped Systems - Other Standard
▼ 10C0001511 Florida Specialty Surgery Center, Llc 6345 54th Ave N Saint Petersburg FL 4 (Atlanta) 09/24/2021 VEQC11 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0221 NOTICE OF RIGHTS Standard
▼ 10C0001511 Florida Specialty Surgery Center, Llc 6345 54th Ave N Saint Petersburg FL 4 (Atlanta) 09/24/2021 VEQC21 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
K0372 Subdivision of Building Spaces ? Smoke Barrier Construction Standard
▼ 10C0001511 Florida Specialty Surgery Center, Llc 6345 54th Ave N Saint Petersburg FL 4 (Atlanta) 09/19/2019 39XL11 Complaint
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0240 INFECTION CONTROL Condition
Q0241 SANITARY ENVIRONMENT Standard
Q0242 INFECTION CONTROL PROGRAM Standard
Q0243 INFECTION CONTROL PROGRAM - DIRECTION Standard
Q0244 INFECTION CONTROL PROGRAM - QAPI Standard
Q0245 INFECTION CONTROL PROGRAM Standard
▼ 10C0001512 Tlc Outpatient Surgery And Laser Center 201 W Guava St Lady Lake FL 4 (Atlanta) 07/13/2023 60454-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
K0353 Sprinkler System - Maintenance and Testing Standard
K0761 Maintenance, Inspection & Testing - Doors Standard
K0913 Electrical Systems - Wet Procedure Locations Standard