S&C QCOR ASC 2567s
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ASCs 2567s
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Time Interval

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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
▼ 03C0001328 Mesquite Surgery Center, Llc 7445 East Tanque Verde Road Tucson AZ 9 (San Francisco) 03/11/2021 W7MC11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0000 Initial Comments - Not a Deficiency Citation Memo
E0007 EP Program Patient Population Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0026 Roles Under a Waiver Declared by Secretary Standard
E0039 EP Testing Requirements Standard
Q0122 REAPPRAISALS Standard
▼ 03C0001328 Mesquite Surgery Center, Llc 7445 East Tanque Verde Road Tucson AZ 9 (San Francisco) 05/07/2019 MHNH11 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
Q0080 QUALITY ASSESSMENT AND PERFORMANCE Condition
Q0064 STANDARD LEVEL TAG FOR SURGICAL SERVICES Standard
Q0084 GOVERNING BODY RESPONSIBILITIES Standard
▼ 03C0001334 Advanced Spine And Pain Llc 2563 South Val Vista Drive, Suite 101 Gilbert AZ 9 (San Francisco) 04/30/2021 FSGM21 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0712 Fire Drills Standard
▼ 03C0001334 Advanced Spine And Pain Llc 2563 South Val Vista Drive, Suite 101 Gilbert AZ 9 (San Francisco) 01/31/2019 2GP911 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0000 Initial Comments - Not a Deficiency Citation 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
E0018 Procedures for Tracking of Staff and Patients Standard
E0022 Policies/Procedures for Sheltering in Place 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
E0033 Methods for Sharing Information Standard
E0034 Information on Occupancy/Needs Standard
E0036 EP Training and Testing Standard
E0037 EP Training Program Standard
E0039 EP Testing Requirements Standard
Q0261 PATIENT ASSESSMENT AND ADMISSION Standard
▼ 03C0001334 Advanced Spine And Pain Llc 2563 South Val Vista Drive, Suite 101 Gilbert AZ 9 (San Francisco) 01/31/2019 2GP921 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0291 Emergency Lighting Standard
K0712 Fire Drills Standard
K0761 Maintenance, Inspection & Testing - Doors Standard
K0913 Electrical Systems - Wet Procedure Locations Standard
K0920 Electrical Equipment ? Power Cords and Extension Cords Standard
▼ 03C0001335 Az West Endoscopy Center, Llc 1850 North 95th Avenue, Suite 190 Phoenix AZ 9 (San Francisco) 06/10/2024 63553-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0101 PHYSICAL ENVIRONMENT Standard
▼ 03C0001335 Az West Endoscopy Center, Llc 1850 North 95th Avenue, Suite 190 Phoenix AZ 9 (San Francisco) 06/10/2024 63554-L1 Complaint
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0521 HVAC Standard
▼ 03C0001335 Az West Endoscopy Center, Llc 1850 North 95th Avenue, Suite 190 Phoenix AZ 9 (San Francisco) 11/21/2023 616F0-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
E0013 Development of EP Policies and Procedures Standard
E0020 Policies for Evac. and Primary/Alt. Comm. Standard
K0351 Sprinkler System - Installation Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0521 HVAC Standard
K0712 Fire Drills Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 03C0001335 Az West Endoscopy Center, Llc 1850 North 95th Avenue, Suite 190 Phoenix AZ 9 (San Francisco) 11/08/2023 616F0-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0064 STANDARD LEVEL TAG FOR SURGICAL SERVICES Standard
Q0181 ADMINISTRATION OF DRUGS Standard
▼ 03C0001336 Ev Pain Solutions, Llc 18610 East Rittenhouse, Building A, Suite 101 Queen Creek AZ 9 (San Francisco) 02/21/2018 D68H11 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
E0018 Procedures for Tracking of Staff and Patients Standard
E0022 Policies/Procedures for Sheltering in Place Standard
E0026 Roles Under a Waiver Declared by Secretary Standard
E0039 EP Testing Requirements Standard