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
▼ 16C0001006 Iowa Endoscopy Center 1378 Nw 124th Street, Suite 100 Clive IA 7 (Kansas City) 08/25/2021 38FD11 Focused Infection Control, Other-Fed, Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0241 SANITARY ENVIRONMENT Standard
Q0242 INFECTION CONTROL PROGRAM Standard
▼ 16C0001006 Iowa Endoscopy Center 1378 Nw 124th Street, Suite 100 Clive IA 7 (Kansas City) 02/06/2019 TODL11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0101 PHYSICAL ENVIRONMENT Standard
Q0241 SANITARY ENVIRONMENT Standard
▼ 16C0001009 West Des Moines Ambulatory Surgical Center Inc. 2425 Westown Parkway West Des Moines IA 7 (Kansas City) 01/16/2020 8XYB11 Recertification, Sample Validation
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0241 SANITARY ENVIRONMENT Standard
Q0242 INFECTION CONTROL PROGRAM Standard
▼ 16C0001009 West Des Moines Ambulatory Surgical Center Inc. 2425 Westown Parkway West Des Moines IA 7 (Kansas City) 01/14/2020 8XYB21 Recertification, Sample Validation
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
E0022 Policies/Procedures for Sheltering in Place Standard
E0034 Information on Occupancy/Needs Standard
K0293 Exit Signage Standard
K0341 Fire Alarm System - Installation Standard
K0346 Fire Alarm System - Out of Service Standard
K0354 Sprinkler System - Out of Service Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 16C0001010 Tri-State Surgery Center, Llc 1500 Associates Drive Dubuque IA 7 (Kansas City) 04/10/2025 65C86-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0266 DISCHARGE - ORDER Standard
▼ 16C0001012 Quality Surgicenter 2745 Lincolnway Clinton IA 7 (Kansas City) 02/13/2018 QTUL11 Complaint
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0040 GOVERNING BODY AND MANAGEMENT Condition
Q0080 QUALITY ASSESSMENT AND PERFORMANCE Condition
Q0100 ENVIRONMENT Condition
Q0219 PATIENT RIGHTS Condition
Q0240 INFECTION CONTROL Condition
Q0081 PROGRAM SCOPE; PROGRAM ACTIVITIES Standard
Q0101 PHYSICIAL ENVIRONMENT Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0232 SAFETY Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0242 INFECTION CONTROL PROGRAM Standard
▼ 16C0001013 Orthopaedic Outpatient Surgery Center 1600 60th St, West Des Moines IA 7 (Kansas City) 02/26/2024 62633-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0260 PATIENT ADMISSION, ASSESSMENT AND DISCHARGE Condition
Q0264 POST-SURGICAL ASSESSMENT Standard
Q0266 DISCHARGE - ORDER Standard
▼ 16C0001015 The Iowa Clinic Endoscopy Center 5950 University Avenue, Suite 180 West Des Moines IA 7 (Kansas City) 05/24/2022 4EB79-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0101 PHYSICAL ENVIRONMENT Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0246 COVID-19 Vaccination of Facility Staff Standard
▼ 16C0001015 The Iowa Clinic Endoscopy Center 5950 University Avenue, Suite 180 West Des Moines IA 7 (Kansas City) 02/27/2019 NC8O21 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0291 Emergency Lighting Standard
K0293 Exit Signage Standard
K0346 Fire Alarm System - Out of Service Standard
K0354 Sprinkler System - Out of Service Standard
K0711 Evacuation and Relocation Plan Standard
K0761 Maintenance, Inspection & Testing - Doors Standard
▼ 16C0001015 The Iowa Clinic Endoscopy Center 5950 University Avenue, Suite 180 West Des Moines IA 7 (Kansas City) 02/19/2019 NC8O11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0000 Initial Comments - Not a Deficiency Citation Memo
E0004 Develop EP Plan, Review and Update Annually Standard
E0007 EP Program Patient Population Standard
E0009 Local, State, Tribal Collaboration Process Standard
Q0181 ADMINISTRATION OF DRUGS Standard