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
▼ 04C0001014 Gastroenterology Surgery Center Of Arkansas, Ii, Llc 8908 Kanis Road Little Rock AR 6 (Dallas) 10/06/2022 5DD23-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0140 NURSING SERVICES Condition
Q0240 INFECTION CONTROL Condition
Q0141 ORGANIZATION AND STAFFING Standard
Q0161 ORGANIZATION Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0221 NOTICE OF RIGHTS Standard
Q0232 SAFETY Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0242 INFECTION CONTROL PROGRAM Standard
▼ 04C0001014 Gastroenterology Surgery Center Of Arkansas, Ii, Llc 8908 Kanis Road Little Rock AR 6 (Dallas) 10/05/2022 5DD23-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0223 Doors with Self-Closing Devices Standard
K0325 Alcohol Based Hand Rub Dispenser (ABHR) Standard
K0712 Fire Drills Standard
K0761 Maintenance, Inspection & Testing - Doors Standard
K0916 Essential Electrical Systems ? Alarm Annunciator Standard
K0920 Electrical Equipment ? Power Cords and Extension Cords Standard
K0923 Electrical Equipment ? Ground-Fault Circuit-Interrupter Protection Standard
K0924 Electrical Equipment ? Wet Procedure Locations Standard
▼ 04C0001017 Mountain Home Surgery Center, Inc. 360 Highway 5 North Mountain Home AR 6 (Dallas) 02/26/2020 CBY911 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0221 NOTICE OF RIGHTS Standard
Q0242 INFECTION CONTROL PROGRAM Standard
▼ 04C0001019 The Fayetteville Asc, Llc 3344 North Futrall Drive Fayetteville AR 6 (Dallas) 04/24/2019 3OZ011 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0141 ORGANIZATION AND STAFFING Standard
▼ 04C0001022 St. Vincent Infirmary Medical Center 10001 Lile Drive Little Rock AR 6 (Dallas) 05/23/2018 20YO21 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
E0001 Establishment of the Emergency Program (EP) Condition
E0006 Plan Based on All Hazards Risk Assessment Standard
E0007 EP Program Patient Population Standard
E0009 Local, State, Tribal Collaboration Process Standard
E0013 Development of EP Policies and Procedures Standard
E0018 Procedures for Tracking of Staff and Patients Standard
E0020 Policies for Evac. and Primary/Alt. Comm. Standard
E0022 Policies/Procedures for Sheltering in Place Standard
E0023 Policies/Procedures for Medical Documentation Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0026 Roles Under a Waiver Declared by Secretary Standard
E0029 Development of Communication Plan Standard
E0030 Names and Contact Information Standard
E0031 Emergency Officials Contact Information 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
K0355 Portable Fire Extinguishers Standard
K0908 Gas and Vacuum Piped Systems ? Central Supply System Alarms Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 04C0001022 St. Vincent Infirmary Medical Center 10001 Lile Drive Little Rock AR 6 (Dallas) 05/22/2018 20YO11 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0240 INFECTION CONTROL Condition
Q0101 PHYSICIAL ENVIRONMENT Standard
Q0104 SAFETY FROM FIRE Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0242 INFECTION CONTROL PROGRAM Standard
Q0245 INFECTION CONTROL PROGRAM Standard
▼ 04C0001029 The Rogers Ar Ophthalmology Asc, Llc 3737 West Walnut Rogers AR 6 (Dallas) 03/10/2021 BFKZ11 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
Q0104 SAFETY FROM FIRE Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0264 POST-SURGICAL ASSESSMENT Standard
▼ 04C0001030 The Doctors Surgery Ctr Of Texarkana 3211 Sugar Hill Road Texarkana AR 6 (Dallas) 01/13/2022 EWOC11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0000 Initial Comments - Not a Deficiency Citation Memo
E0006 Plan Based on All Hazards Risk Assessment Standard
E0018 Procedures for Tracking of Staff and Patients Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0026 Roles Under a Waiver Declared by Secretary Standard
Q0101 PHYSICAL ENVIRONMENT Standard
Q0104 SAFETY FROM FIRE Standard
Q0108 BUILDING SAFETY Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0232 SAFETY Standard
Q0233 SAFETY - ABUSE/HARASSMENT Standard
Q0241 SANITARY ENVIRONMENT Standard
▼ 04C0001031 James Trice, Md, Pa 7005 South Hazel Street Pine Bluff AR 6 (Dallas) 05/06/2021 8CZO11 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
E0006 Plan Based on All Hazards Risk Assessment Standard
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
Q0064 STANDARD LEVEL TAG FOR SURGICAL SERVICES Standard
Q0104 SAFETY FROM FIRE Standard
Q0108 BUILDING SAFETY Standard
Q0109 EMERGENCY EQUIPMENT Standard
Q0141 ORGANIZATION AND STAFFING Standard
Q0162 FORM AND CONTENT OF RECORD Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0223 NOTICE - PHYSICIAN OWNERSHIP Standard
Q0233 SAFETY - ABUSE/HARASSMENT Standard
Q0242 INFECTION CONTROL PROGRAM Standard
Q0243 INFECTION CONTROL PROGRAM - DIRECTION Standard
▼ 04C0001033 Arkansas Gastroenterology Endosocopy Center, Llc 151 Mcgowan Court Hot Springs AR 6 (Dallas) 06/30/2021 NVO511 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0162 FORM AND CONTENT OF RECORD Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0232 SAFETY Standard
Q0242 INFECTION CONTROL PROGRAM Standard