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
▼ 11C0001525 Georgia Interventional Pain F, Llc 1357 Hembree Rd, Ste 230 Roswell GA 4 (Atlanta) 09/01/2020 NQ8L21 Initial Certification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
E0030 Names and Contact Information Standard
E0031 Emergency Officials Contact Information Standard
K0353 Sprinkler System - Maintenance and Testing Standard
▼ 11C0001580 Asc Of Baucom & Mina Dermsurgery Johnscreek, Llc 10750 Medlock Bridge Rd Suite 102 Johns Creek GA 4 (Atlanta) 10/22/2024 646A5-L1 Initial Certification
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
▼ 11C0001584 Advanced Center For Joint Replacement, Gwinnett, Llc 2800 Buford Drive Ste 400 Buford GA 4 (Atlanta) 01/27/2025 651DF-L1 Initial Certification
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
▼ 11C0001588 Summit Endoscopy Center Newnan, Llc 1665 Hwy 34 East Suite 200 Newnan GA 4 (Atlanta) 05/05/2025 660B6-L1 Initial Certification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
K0371 Subdivision of Building Spaces ? Smoke Compartments Standard
▼ 11C0001594 Limbs Vascular Interventions Asc, Llc 1825 Highway 34 East Suite 3400a Newnan GA 4 (Atlanta) 09/29/2025 1D5CD4-L1 Initial Certification
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
K0344 Fire Alarm - Control Functions Standard
▼ 11C0001597 Ipc Dalton Asc, Llc 1502 Dug Gap Road Dalton GA 4 (Atlanta) 02/11/2026 1E214A-L1 Initial Certification
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
K0920 Electrical Equipment ? Power Cords and Extension Cords Standard
K0921 Electrical Equipment ? Testing and Maintenance Requirements Standard
▼ 12C0001006 Cataract & Vision Center Of Hawaii 1712 Liliha Street, Suite 400 Honolulu HI 9 (San Francisco) 01/10/2022 MEM411 Complaint
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
E0001 Establishment of the Emergency Program (EP) Condition
Q0040 GOVERNING BODY AND MANAGEMENT Condition
Q0140 NURSING SERVICES Condition
Q0160 MEDICAL RECORDS Condition
Q0180 PHARMACEUTICAL SERVICES Condition
Q0219 PATIENT RIGHTS Condition
E0006 Plan Based on All Hazards Risk Assessment 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
E0031 Emergency Officials Contact Information Standard
Q0002 DEFINITIONS Standard
Q0084 GOVERNING BODY RESPONSIBILITIES Standard
Q0102 SEPARATION Standard
Q0109 EMERGENCY EQUIPMENT Standard
Q0121 MEMBERSHIP AND CLINICAL PRIVILEGES Standard
Q0123 OTHER PRACTITIONERS Standard
Q0161 ORGANIZATION Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0220 NOTICE - POSTING Standard
Q0221 NOTICE OF RIGHTS Standard
Q0222 NOTICE OF RIGHTS - POSTING Standard
Q0224 ADVANCED DIRECTIVES Standard
Q0225 SUBMISSION AND INVESTIGATION OF GRIEVANCES Standard
Q0232 SAFETY Standard
Q0234 CONFIDENTIALITY OF CLINICAL RECORDS Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0245 INFECTION CONTROL PROGRAM Standard
Q0262 ADMISSION AND PRE-SURGICAL ASSESSMENT Standard
Q0264 POST-SURGICAL ASSESSMENT Standard
Q0267 DISCHARGE WITH RESPONSIBLE ADULT Standard
▼ 12C0001009 Aloha Surgical Center, Llc 239 Ho'Ohana Street Kahului HI 9 (San Francisco) 08/15/2019 E0J611 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0101 PHYSICAL ENVIRONMENT Standard
Q0141 ORGANIZATION AND STAFFING Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0242 INFECTION CONTROL PROGRAM Standard
Q0261 PATIENT ASSESSMENT AND ADMISSION Standard
Q0262 ADMISSION AND PRE-SURGICAL ASSESSMENT Standard
▼ 12C0001018 Kona Ambulatory Surgery Center Llc 75-5905 Walua Road, Unit 4 Kailua Kona HI 9 (San Francisco) 04/05/2022 D5GX21 Recertification
Deficiency Tag Deficiency Description Tag Type
E0039 EP Testing Requirements Standard
K0293 Exit Signage Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0353 Sprinkler System - Maintenance and Testing Standard
▼ 12C0001018 Kona Ambulatory Surgery Center Llc 75-5905 Walua Road, Unit 4 Kailua Kona HI 9 (San Francisco) 03/18/2022 D5GX11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0220 NOTICE - POSTING Standard
Q0221 NOTICE OF RIGHTS Standard