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
▼ 23C0001006 St Clair Shores Mi Ophthalmology Asc, Llc 21711 Greater Mack Ave St Clair Shores MI 5 (Chicago) 08/17/2022 4F36B-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
▼ 23C0001009 Holland Eye Clinic 999 S. Washington Holland MI 5 (Chicago) 02/17/2022 V1Q811 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0080 QUALITY ASSESSMENT AND PERFORMANCE Condition
Q0081 PROGRAM SCOPE; PROGRAM ACTIVITIES Standard
Q0083 PERFORMANCE IMPROVEMENT PROJECTS Standard
Q0084 GOVERNING BODY RESPONSIBILITIES Standard
Q0101 PHYSICAL ENVIRONMENT Standard
Q0104 SAFETY FROM FIRE Standard
Q0228 EXERCISE OF RIGHTS - GRIEVANCES Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0242 INFECTION CONTROL PROGRAM Standard
▼ 23C0001009 Holland Eye Clinic 999 S. Washington Holland MI 5 (Chicago) 02/16/2022 V1Q821 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
E0029 Development of Communication Plan Standard
K0131 Multiple Occupancies Standard
K0712 Fire Drills Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 23C0001017 Cukrowski Surgery Center 701 S Ballenger Highway Flint MI 5 (Chicago) 03/25/2026 1F565D-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0100 ENVIRONMENT Condition
Q0101 PHYSICAL ENVIRONMENT Standard
Q0104 SAFETY FROM FIRE Standard
Q0242 INFECTION CONTROL PROGRAM Standard
▼ 23C0001017 Cukrowski Surgery Center 701 S Ballenger Highway Flint MI 5 (Chicago) 03/25/2026 1F565D-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
K0131 Multiple Occupancies Standard
K0321 Hazardous Areas - Enclosure Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0781 Portable Space Heaters Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 23C0001020 Ebsc, Llc 750 East Beltline Ave Ne Grand Rapids MI 5 (Chicago) 01/05/2023 5E997-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0101 PHYSICAL ENVIRONMENT Standard
Q0104 SAFETY FROM FIRE Standard
Q0241 SANITARY ENVIRONMENT Standard
▼ 23C0001020 Ebsc, Llc 750 East Beltline Ave Ne Grand Rapids MI 5 (Chicago) 01/04/2023 5E997-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
K0131 Multiple Occupancies Standard
▼ 23C0001021 Surgery Center Of Michigan 44650 Delco Boulevard, Suite 200 Sterling Heights MI 5 (Chicago) 05/16/2024 630D4-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0100 ENVIRONMENT Condition
Q0101 PHYSICAL ENVIRONMENT Standard
Q0104 SAFETY FROM FIRE Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0241 SANITARY ENVIRONMENT Standard
▼ 23C0001021 Surgery Center Of Michigan 44650 Delco Boulevard, Suite 200 Sterling Heights MI 5 (Chicago) 05/16/2024 630D4-L1 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
K0351 Sprinkler System - Installation Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0511 Utilities - Gas and Electric Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
K0920 Electrical Equipment ? Power Cords and Extension Cords Standard
▼ 23C0001021 Surgery Center Of Michigan 44650 Delco Boulevard, Suite 200 Sterling Heights MI 5 (Chicago) 02/20/2019 6T0011 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0040 GOVERNING BODY AND MANAGEMENT Condition
Q0219 PATIENT RIGHTS Condition
Q0064 STANDARD LEVEL TAG FOR SURGICAL SERVICES Standard
Q0101 PHYSICAL ENVIRONMENT Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0222 NOTICE OF RIGHTS - POSTING Standard
Q0232 SAFETY Standard