S&C QCOR ASC 2567s
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ASCs 2567s
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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
▼ 11C0001299 Coastal Pain Center, Llc 3221 Glynn Avenue Brunswick GA 4 (Atlanta) 07/01/2019 49K721 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
E0001 Establishment of the Emergency Program (EP) Condition
E0004 Develop EP Plan, Review and Update Annually Standard
E0006 Plan Based on All Hazards Risk Assessment Standard
E0007 EP Program Patient Population Standard
E0009 Local, State, Tribal Collaboration Process Standard
E0013 Development of EP Policies and Procedures Standard
E0018 Procedures for Tracking of Staff and Patients Standard
E0020 Policies for Evac. and Primary/Alt. Comm. Standard
E0022 Policies/Procedures for Sheltering in Place Standard
E0026 Roles Under a Waiver Declared by Secretary Standard
E0029 Development of Communication Plan Standard
E0031 Emergency Officials Contact Information Standard
E0036 EP Training and Testing Standard
E0037 EP Training Program Standard
E0039 EP Testing Requirements Standard
▼ 11C0001300 Universal Ambulatory Surgery Center, P.C. 1911 Warm Springs Road, Suite 1a Columbus GA 4 (Atlanta) 12/12/2019 FLUB11 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0081 PROGRAM SCOPE; PROGRAM ACTIVITIES Standard
Q0122 REAPPRAISALS Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0241 SANITARY ENVIRONMENT Standard
▼ 11C0001300 Universal Ambulatory Surgery Center, P.C. 1911 Warm Springs Road, Suite 1a Columbus GA 4 (Atlanta) 12/09/2019 FLUB21 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
E0001 Establishment of the Emergency Program (EP) Condition
K0281 Illumination of Means of Egress Standard
K0293 Exit Signage Standard
K0321 Hazardous Areas - Enclosure Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0711 Evacuation and Relocation Plan Standard
K0761 Maintenance, Inspection & Testing - Doors Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 11C0001303 Newnan Foot & Ankle Surgery Center, Llc 3231 Highway 34 East, Suite B Newnan GA 4 (Atlanta) 02/05/2018 VXIX21 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
E0001 Establishment of the Emergency Program (EP) Condition
K0341 Fire Alarm System - Installation Standard
▼ 11C0001308 Rome Surgical Center, P.C. 211 Redmond Road Rome GA 4 (Atlanta) 05/01/2019 H6LO11 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0061 ANESTHETIC RISK AND EVALUATION Standard
Q0081 PROGRAM SCOPE; PROGRAM ACTIVITIES Standard
Q0083 PERFORMANCE IMPROVEMENT PROJECTS Standard
Q0122 REAPPRAISALS Standard
Q0225 SUBMISSION AND INVESTIGATION OF GRIEVANCES Standard
Q0243 INFECTION CONTROL PROGRAM - DIRECTION Standard
▼ 11C0001308 Rome Surgical Center, P.C. 211 Redmond Road Rome GA 4 (Atlanta) 04/30/2019 H6LO21 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
K0293 Exit Signage Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0355 Portable Fire Extinguishers Standard
▼ 11C0001309 Northview Orthopaedic Surgery Center, P.C. 70 Ansley Drive Dahlonega GA 4 (Atlanta) 07/15/2019 9V3821 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
K0341 Fire Alarm System - Installation Standard
▼ 11C0001311 Augusta Eye Surgery, Llc 905 Stevens Creek Road Augusta GA 4 (Atlanta) 10/16/2019 6R0O21 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
E0001 Establishment of the Emergency Program (EP) Condition
K0211 Means of Egress - General Standard
K0291 Emergency Lighting Standard
K0341 Fire Alarm System - Installation Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0372 Subdivision of Building Spaces ? Smoke Barrier Construction Standard
K0511 Utilities - Gas and Electric Standard
K0761 Maintenance, Inspection & Testing - Doors Standard
K0781 Portable Space Heaters Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
K0923 Electrical Equipment ? Ground-Fault Circuit-Interrupter Protection Standard
▼ 11C0001312 Savannah Pain Center, Llc 8 Wheeler Street, Suite 200 Savannah GA 4 (Atlanta) 10/07/2025 1D853D-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
K0293 Exit Signage Standard
K0761 Maintenance, Inspection & Testing - Doors Standard
▼ 11C0001313 Premier Orthopedic Surgicenter, Llc 2405 Osler Court, Suite 100 Albany GA 4 (Atlanta) 03/06/2018 KGUS21 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
E0018 Procedures for Tracking of Staff and Patients Standard
E0030 Names and Contact Information Standard
E0032 Primary/Alternate Means for Communication Standard
E0036 EP Training and Testing Standard
E0037 EP Training Program Standard
E0039 EP Testing Requirements Standard