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
▼ 17C0001038 Kansas Endoscopy Llc 3121 North Webb Road Suite 107 Wichita KS 7 (Kansas City) 03/07/2018 XDX411 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0240 INFECTION CONTROL Condition
Q0041 CONTRACT SERVICES Standard
Q0062 ANESTHETIC - DISCHARGE Standard
Q0064 STANDARD LEVEL TAG FOR SURGICAL SERVICES Standard
Q0082 PROGRAM DATA; PROGRAM ACTIVITIES Standard
Q0121 MEMBERSHIP AND CLINICAL PRIVILEGES Standard
Q0122 REAPPRAISALS Standard
Q0161 ORGANIZATION Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0221 NOTICE OF RIGHTS Standard
Q0234 CONFIDENTIALITY OF CLINICAL RECORDS Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0242 INFECTION CONTROL PROGRAM Standard
Q0265 DISCHARGE - SUPPLIES AND INFORMATION Standard
▼ 17C0001038 Kansas Endoscopy Llc 3121 North Webb Road Suite 107 Wichita KS 7 (Kansas City) 03/06/2018 XDX421 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0712 Fire Drills Standard
▼ 17C0001039 Midwest Surgery Center Lc 825 North Hillside Suite 100 Wichita KS 7 (Kansas City) 03/20/2024 62829-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0120 MEDICAL STAFF Condition
Q0240 INFECTION CONTROL Condition
Q0041 CONTRACT SERVICES Standard
Q0064 STANDARD LEVEL TAG FOR SURGICAL SERVICES Standard
Q0122 REAPPRAISALS Standard
Q0123 OTHER PRACTITIONERS Standard
Q0229 EXERCISE OF RIGHTS - INFORMED CONSENT Standard
Q0232 SAFETY Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0242 INFECTION CONTROL PROGRAM Standard
Q0243 INFECTION CONTROL PROGRAM - DIRECTION Standard
Q0262 ADMISSION AND PRE-SURGICAL ASSESSMENT Standard
Q0266 DISCHARGE - ORDER Standard
▼ 17C0001039 Midwest Surgery Center Lc 825 North Hillside Suite 100 Wichita KS 7 (Kansas City) 03/19/2024 62829-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS 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
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0026 Roles Under a Waiver Declared by Secretary Standard
E0032 Primary/Alternate Means for Communication Standard
E0033 Methods for Sharing Information Standard
E0036 EP Training and Testing Standard
E0037 EP Training Program Standard
E0039 EP Testing Requirements Standard
K0325 Alcohol Based Hand Rub Dispenser (ABHR) Standard
K0341 Fire Alarm System - Installation Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0712 Fire Drills Standard
▼ 17C0001042 Ku Medwest Ambulatory Surgery Center Llc 7405 Renner Road Shawnee KS 7 (Kansas City) 11/07/2024 6494C-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0240 INFECTION CONTROL Condition
Q0221 NOTICE OF RIGHTS Standard
Q0229 EXERCISE OF RIGHTS - INFORMED CONSENT Standard
Q0241 SANITARY ENVIRONMENT Standard
▼ 17C0001042 Ku Medwest Ambulatory Surgery Center Llc 7405 Renner Road Shawnee KS 7 (Kansas City) 11/06/2024 6494C-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
E0009 Local, State, Tribal Collaboration Process Standard
E0018 Procedures for Tracking of Staff and Patients Standard
E0023 Policies/Procedures for Medical Documentation Standard
E0026 Roles Under a Waiver Declared by Secretary Standard
E0033 Methods for Sharing Information Standard
K0163 Interior Nonbearing Wall Construction Standard
K0211 Means of Egress - General Standard
K0291 Emergency Lighting Standard
K0325 Alcohol Based Hand Rub Dispenser (ABHR) Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0754 Soiled Linen and Trash Containers Standard
K0761 Maintenance, Inspection & Testing - Doors Standard
K0914 Electrical Systems - Maintenance and Testing Standard
▼ 17C0001044 Ads Healthcare, L.L.C 6901 W 121st Street Overland Park KS 7 (Kansas City) 08/06/2024 63CC8-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0181 ADMINISTRATION OF DRUGS Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0242 INFECTION CONTROL PROGRAM Standard
▼ 17C0001045 Freeman Surgical Center Of Pittsburg, Llc 100 North Pine Pittsburg KS 7 (Kansas City) 01/15/2026 1E06F7-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0062 ANESTHETIC - DISCHARGE Standard
Q0065 PHYSICIAN EVALUATION OF RISK Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0242 INFECTION CONTROL PROGRAM Standard
Q0261 PATIENT ASSESSMENT AND ADMISSION Standard
▼ 17C0001045 Freeman Surgical Center Of Pittsburg, Llc 100 North Pine Pittsburg KS 7 (Kansas City) 12/28/2018 D1VG21 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0345 Fire Alarm System - Testing and Maintenance Standard
K0371 Subdivision of Building Spaces ? Smoke Compartments Standard
K0914 Electrical Systems - Maintenance and Testing Standard
▼ 17C0001045 Freeman Surgical Center Of Pittsburg, Llc 100 North Pine Pittsburg KS 7 (Kansas City) 12/18/2018 D1VG11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0219 PATIENT RIGHTS Condition
Q0240 INFECTION CONTROL Condition
Q0220 NOTICE - POSTING Standard
Q0221 NOTICE OF RIGHTS Standard
Q0222 NOTICE OF RIGHTS - POSTING Standard
Q0242 INFECTION CONTROL PROGRAM Standard