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
▼ 21C0001136 Michael L Michetti, Dr Pa 702 Russell Avenue, Suite 103 Gaithersburg MD 3 (Philadelphia) 05/19/2021 6B0Y21 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
E0004 Develop EP Plan, Review and Update Annually Standard
K0902 Gas and Vacuum Piped Systems - Other Standard
K0907 Gas and Vacuum Piped Systems ? Central Supply System Location Standard
K0908 Gas and Vacuum Piped Systems ? Central Supply System Alarms Standard
K0910 Gas and Vacuum Piped Systems - Modifications Standard
K0914 Electrical Systems - Maintenance and Testing Standard
K0920 Electrical Equipment ? Power Cords and Extension Cords Standard
K0921 Electrical Equipment ? Testing and Maintenance Requirements Standard
▼ 21C0001136 Michael L Michetti, Dr Pa 702 Russell Avenue, Suite 103 Gaithersburg MD 3 (Philadelphia) 05/07/2021 6B0Y11 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0060 SURGICAL SERVICES Condition
Q0064 STANDARD LEVEL TAG FOR SURGICAL SERVICES Standard
Q0123 OTHER PRACTITIONERS Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0242 INFECTION CONTROL PROGRAM Standard
Q0262 ADMISSION AND PRE-SURGICAL ASSESSMENT Standard
▼ 21C0001136 Michael L Michetti, Dr Pa 702 Russell Avenue, Suite 103 Gaithersburg MD 3 (Philadelphia) 01/10/2018 WVXM21 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
K0342 Fire Alarm System - Initiation Standard
K0923 Electrical Equipment ? Ground-Fault Circuit-Interrupter Protection Standard
▼ 21C0001139 The Eye Surgery Center 8905 Fairview Road Silver Spring MD 3 (Philadelphia) 03/21/2023 5F0EE-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
K0291 Emergency Lighting Standard
K0293 Exit Signage Standard
▼ 21C0001139 The Eye Surgery Center 8905 Fairview Road Silver Spring MD 3 (Philadelphia) 10/08/2019 P55711 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0042 HOSPITALIZATION Standard
▼ 21C0001140 Maryland Endoscopy Cntr Limit Liab Com 100 West Road Suite 115 Baltimore MD 3 (Philadelphia) 05/10/2022 CKSW21 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 21C0001142 Summit Ambulatory Surgery Center, Llc 10710 Charter Drive, Suite 140 Columbia MD 3 (Philadelphia) 12/11/2019 0DQ021 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
E0033 Methods for Sharing Information Standard
K0374 Subdivision of Building Spaces ? Smoke Barrier Doors Standard
K0711 Evacuation and Relocation Plan Standard
K0761 Maintenance, Inspection & Testing - Doors Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
K0920 Electrical Equipment ? Power Cords and Extension Cords Standard
▼ 21C0001143 Adam Spector Dpm Asc 2730 University Blvd West, Suite1000 Wheaton MD 3 (Philadelphia) 02/14/2019 WLJI21 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
K0345 Fire Alarm System - Testing and Maintenance Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0355 Portable Fire Extinguishers Standard
▼ 21C0001146 D & P, Llc 2086 Generals Highway #101 Annapolis MD 3 (Philadelphia) 03/28/2018 RRG711 Recertification
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
Q0120 MEDICAL STAFF Condition
Q0180 PHARMACEUTICAL SERVICES Condition
Q0081 PROGRAM SCOPE; PROGRAM ACTIVITIES Standard
Q0084 GOVERNING BODY RESPONSIBILITIES Standard
Q0101 PHYSICIAL ENVIRONMENT Standard
Q0104 SAFETY FROM FIRE Standard
Q0121 MEMBERSHIP AND CLINICAL PRIVILEGES Standard
Q0123 OTHER PRACTITIONERS Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0242 INFECTION CONTROL PROGRAM Standard
▼ 21C0001147 St Mary's Multi-Specialty Surgery Center 22325 Greenview Parkway, West Great Mills MD 3 (Philadelphia) 07/25/2023 6012D-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
K0291 Emergency Lighting Standard
K0293 Exit Signage Standard
K0355 Portable Fire Extinguishers Standard
K0712 Fire Drills Standard
K0921 Electrical Equipment ? Testing and Maintenance Requirements Standard