S&C QCOR ASC 2567s
d QCOR: Quality, Certification and Oversight Reports. S&C QCOR  
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ASCs 2567s
Selection Criteria ▸

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
▼ 16C0001028 Pierce Street Same Day Surgery 2730 Pierce Street Sioux City IA 7 (Kansas City) 09/18/2024 64240-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0162 FORM AND CONTENT OF RECORD Standard
▼ 16C0001028 Pierce Street Same Day Surgery 2730 Pierce Street Sioux City IA 7 (Kansas City) 07/17/2023 60005-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
Q0242 INFECTION CONTROL PROGRAM Standard
▼ 16C0001028 Pierce Street Same Day Surgery 2730 Pierce Street Sioux City IA 7 (Kansas City) 07/13/2023 60005-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0345 Fire Alarm System - Testing and Maintenance Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0761 Maintenance, Inspection & Testing - Doors Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
K0926 Gas Equipment - Qualifications and Training Standard
▼ 16C0001028 Pierce Street Same Day Surgery 2730 Pierce Street Sioux City IA 7 (Kansas City) 09/03/2020 RCIN11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0002 DEFINITIONS Standard
Q0141 ORGANIZATION AND STAFFING Standard
Q0162 FORM AND CONTENT OF RECORD Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0232 SAFETY Standard
▼ 16C0001028 Pierce Street Same Day Surgery 2730 Pierce Street Sioux City IA 7 (Kansas City) 09/02/2020 RCIN21 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0345 Fire Alarm System - Testing and Maintenance Standard
K0346 Fire Alarm System - Out of Service Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0354 Sprinkler System - Out of Service Standard
K0761 Maintenance, Inspection & Testing - Doors Standard
K0923 Electrical Equipment ? Ground-Fault Circuit-Interrupter Protection Standard
▼ 16C0001029 Iowa City Ambulatory Surgery Center Llc 2963 Northgate Drive Iowa City IA 7 (Kansas City) 11/22/2022 5E654-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0162 FORM AND CONTENT OF RECORD Standard
▼ 16C0001029 Iowa City Ambulatory Surgery Center Llc 2963 Northgate Drive Iowa City IA 7 (Kansas City) 01/18/2022 A5IW11 Complaint
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0121 MEMBERSHIP AND CLINICAL PRIVILEGES Standard
▼ 16C0001030 Wolfe Surgery Center, Llc 6100 Westown Parkway, Suite 100 West Des Moines IA 7 (Kansas City) 04/18/2019 QRQU11 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
Q0109 EMERGENCY EQUIPMENT Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0242 INFECTION CONTROL PROGRAM Standard
▼ 16C0001030 Wolfe Surgery Center, Llc 6100 Westown Parkway, Suite 100 West Des Moines IA 7 (Kansas City) 04/15/2019 QRQU21 Recertification, Sample Validation
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0345 Fire Alarm System - Testing and Maintenance Standard
K0346 Fire Alarm System - Out of Service Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0354 Sprinkler System - Out of Service Standard
K0911 Electrical Systems - Other Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 16C0001032 Ankeny Medical Park Surgery Center 3625 N Ankeny Blvd Ste J Ankeny IA 7 (Kansas City) 08/02/2023 60007-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