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
▼ 12C0001018 Kona Ambulatory Surgery Center Llc 75-5905 Walua Road, Unit 4 Kailua Kona HI 9 (San Francisco) 12/10/2019 LHBW11 Complaint
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0040 GOVERNING BODY AND MANAGEMENT Condition
Q0060 SURGICAL SERVICES Condition
Q0100 ENVIRONMENT Condition
Q0219 PATIENT RIGHTS Condition
Q0042 HOSPITALIZATION Standard
Q0064 STANDARD LEVEL TAG FOR SURGICAL SERVICES Standard
Q0232 SAFETY Standard
▼ 12C0001022 Surgical Specialties Llc 1329 Lusitana St, Suite 401 Hon HI 9 (San Francisco) 10/15/2021 5QHD21 Recertification
Deficiency Tag Deficiency Description Tag Type
E0006 Plan Based on All Hazards Risk Assessment Standard
K0291 Emergency Lighting Standard
K0711 Evacuation and Relocation Plan Standard
K0712 Fire Drills Standard
K0761 Maintenance, Inspection & Testing - Doors Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 12C0001022 Surgical Specialties Llc 1329 Lusitana St, Suite 401 Hon HI 9 (San Francisco) 09/10/2021 5QHD11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0162 FORM AND CONTENT OF RECORD Standard
Q0232 SAFETY Standard
Q0265 DISCHARGE - SUPPLIES AND INFORMATION Standard
Q0266 DISCHARGE - ORDER Standard
▼ 12C0001023 Specialty Surgical Suites, Llc 1401 South Beretania Street, Suite 600 Honolulu HI 9 (San Francisco) 12/26/2024 64FAA-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0040 GOVERNING BODY AND MANAGEMENT Condition
Q0082 PROGRAM DATA; PROGRAM ACTIVITIES Standard
▼ 13C0001003 Surgery Center 115 Falls Avenue West Twin Falls ID 10 (Seattle) 07/09/2024 63615-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
K0161 Building Construction Type and Height Standard
K0321 Hazardous Areas - Enclosure Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0355 Portable Fire Extinguishers Standard
K0511 Utilities - Gas and Electric Standard
K0521 HVAC Standard
K0712 Fire Drills Standard
K0761 Maintenance, Inspection & Testing - Doors Standard
▼ 13C0001003 Surgery Center 115 Falls Avenue West Twin Falls ID 10 (Seattle) 06/13/2024 63615-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0081 PROGRAM SCOPE; PROGRAM ACTIVITIES Standard
Q0083 PERFORMANCE IMPROVEMENT PROJECTS Standard
Q0101 PHYSICAL ENVIRONMENT Standard
Q0162 FORM AND CONTENT OF RECORD Standard
▼ 13C0001009 North Idaho Cataract & Laser Cntr Inc 1814 Lincoln Way Coeur D'Alene ID 10 (Seattle) 07/08/2025 66989-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
▼ 13C0001009 North Idaho Cataract & Laser Cntr Inc 1814 Lincoln Way Coeur D'Alene ID 10 (Seattle) 07/02/2025 66989-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0162 FORM AND CONTENT OF RECORD Standard
Q0241 SANITARY ENVIRONMENT Standard
▼ 13C0001010 Idaho Endoscopy Center Llc 6259 West Emerald Street Boise ID 10 (Seattle) 04/26/2018 W8VU21 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0026 Roles Under a Waiver Declared by Secretary Standard
▼ 13C0001010 Idaho Endoscopy Center Llc 6259 West Emerald Street Boise ID 10 (Seattle) 01/11/2018 W8VU11 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0160 MEDICAL RECORDS Condition
Q0002 DEFINITIONS Standard
Q0161 ORGANIZATION Standard
Q0162 FORM AND CONTENT OF RECORD Standard
Q0184 VERBAL ORDERS Standard
Q0221 NOTICE OF RIGHTS Standard
Q0224 ADVANCED DIRECTIVES Standard
Q0225 SUBMISSION AND INVESTIGATION OF GRIEVANCES Standard
Q0229 EXERCISE OF RIGHTS - INFORMED CONSENT Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0263 ADMISSION ASSESSMENT - RECORD Standard