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
▼ 03C0001316 Mesa Surgical Center, Llc 1114 South Higley Road, Suite 101 Mesa AZ 9 (San Francisco) 07/15/2019 2HBH21 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0291 Emergency Lighting Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0761 Maintenance, Inspection & Testing - Doors Standard
K0914 Electrical Systems - Maintenance and Testing Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 03C0001319 Pain Mds Ambulatory Surgical Center, Llc 16390 North 59th Avenue, Suite 100 Glendale AZ 9 (San Francisco) 02/16/2021 5EPL11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0000 Initial Comments - Not a Deficiency Citation Memo
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
E0036 EP Training and Testing Standard
▼ 03C0001319 Pain Mds Ambulatory Surgical Center, Llc 16390 North 59th Avenue, Suite 100 Glendale AZ 9 (San Francisco) 02/16/2021 5EPL21 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0372 Subdivision of Building Spaces ? Smoke Barrier Construction Standard
K0908 Gas and Vacuum Piped Systems ? Central Supply System Alarms Standard
K0920 Electrical Equipment ? Power Cords and Extension Cords Standard
▼ 03C0001321 Omni Business Operations, Llc 2155 East Conference Drive, Suite 111 Tempe AZ 9 (San Francisco) 05/31/2022 4EBDF-L1 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
E0007 EP Program Patient Population Standard
E0009 Local, State, Tribal Collaboration Process Standard
E0013 Development of EP Policies and Procedures Standard
E0020 Policies for Evac. and Primary/Alt. Comm. Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0026 Roles Under a Waiver Declared by Secretary Standard
E0029 Development of Communication Plan Standard
E0032 Primary/Alternate Means for Communication Standard
E0034 Information on Occupancy/Needs Standard
E0036 EP Training and Testing Standard
E0037 EP Training Program Standard
E0039 EP Testing Requirements Standard
K0131 Multiple Occupancies Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0521 HVAC Standard
K0712 Fire Drills Standard
K0761 Maintenance, Inspection & Testing - Doors Standard
K0908 Gas and Vacuum Piped Systems ? Central Supply System Alarms Standard
K0923 Electrical Equipment ? Ground-Fault Circuit-Interrupter Protection Standard
K0926 Gas Equipment - Qualifications and Training Standard
▼ 03C0001322 Laser Surgery Holding Company, Ltd. 10255 North 32nd Street Phoenix AZ 9 (San Francisco) 04/28/2021 NIDD11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0000 Initial Comments - Not a Deficiency Citation Memo
E0037 EP Training Program Standard
E0039 EP Testing Requirements Standard
▼ 03C0001322 Laser Surgery Holding Company, Ltd. 10255 North 32nd Street Phoenix AZ 9 (San Francisco) 04/28/2021 NIDD21 Complaint, Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0291 Emergency Lighting Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0374 Subdivision of Building Spaces ? Smoke Barrier Doors Standard
K0521 HVAC Standard
K0761 Maintenance, Inspection & Testing - Doors Standard
K0914 Electrical Systems - Maintenance and Testing Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 03C0001322 Laser Surgery Holding Company, Ltd. 10255 North 32nd Street Phoenix AZ 9 (San Francisco) 11/14/2018 BIGJ11 Recertification, Sample Validation
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0000 Initial Comments - Not a Deficiency Citation Memo
E0026 Roles Under a Waiver Declared by Secretary Standard
▼ 03C0001322 Laser Surgery Holding Company, Ltd. 10255 North 32nd Street Phoenix AZ 9 (San Francisco) 11/14/2018 BIGJ21 Recertification, Sample Validation
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0291 Emergency Lighting Standard
K0321 Hazardous Areas - Enclosure Standard
K0511 Utilities - Gas and Electric Standard
K0521 HVAC Standard
K0761 Maintenance, Inspection & Testing - Doors Standard
K0908 Gas and Vacuum Piped Systems ? Central Supply System Alarms Standard
K0913 Electrical Systems - Wet Procedure Locations Standard
K0914 Electrical Systems - Maintenance and Testing Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 03C0001325 North Scottsdale Outpatient Surgery Center 8913 East Bell Road, Suite 101 Scottsdale AZ 9 (San Francisco) 11/29/2023 6188B-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
E0020 Policies for Evac. and Primary/Alt. Comm. Standard
E0039 EP Testing Requirements Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0521 HVAC Standard
K0761 Maintenance, Inspection & Testing - Doors Standard
▼ 03C0001325 North Scottsdale Outpatient Surgery Center 8913 East Bell Road, Suite 101 Scottsdale AZ 9 (San Francisco) 08/20/2018 0LUD21 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0131 Multiple Occupancies Standard