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
▼ 23C0001069 Kalamazoo Endo Center, Llc 3300 Cooley Court Portage MI 5 (Chicago) 07/14/2020 X8KG11 Focused Infection Control, Other-Fed
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0242 INFECTION CONTROL PROGRAM Standard
▼ 23C0001069 Kalamazoo Endo Center, Llc 3300 Cooley Court Portage MI 5 (Chicago) 05/29/2019 L6LM11 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
Q0121 MEMBERSHIP AND CLINICAL PRIVILEGES Standard
Q0225 SUBMISSION AND INVESTIGATION OF GRIEVANCES Standard
Q0242 INFECTION CONTROL PROGRAM Standard
▼ 23C0001070 Royal Oak Surgery Center, Pllc 5130 Coolidge Highway, #120 Royal Oak MI 5 (Chicago) 01/03/2025 64F43-H1 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
Q0100 ENVIRONMENT Condition
Q0120 MEDICAL STAFF Condition
Q0180 PHARMACEUTICAL SERVICES Condition
Q0240 INFECTION CONTROL Condition
Q0041 CONTRACT SERVICES Standard
Q0042 HOSPITALIZATION Standard
Q0081 PROGRAM SCOPE; PROGRAM ACTIVITIES Standard
Q0082 PROGRAM DATA; PROGRAM ACTIVITIES Standard
Q0083 PERFORMANCE IMPROVEMENT PROJECTS Standard
Q0084 GOVERNING BODY RESPONSIBILITIES Standard
Q0101 PHYSICAL ENVIRONMENT Standard
Q0104 SAFETY FROM FIRE Standard
Q0121 MEMBERSHIP AND CLINICAL PRIVILEGES Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0225 SUBMISSION AND INVESTIGATION OF GRIEVANCES Standard
Q0242 INFECTION CONTROL PROGRAM Standard
Q0244 INFECTION CONTROL PROGRAM - QAPI Standard
Q0245 INFECTION CONTROL PROGRAM Standard
▼ 23C0001070 Royal Oak Surgery Center, Pllc 5130 Coolidge Highway, #120 Royal Oak MI 5 (Chicago) 01/02/2025 64F43-L1 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
E0036 EP Training and Testing Standard
E0039 EP Testing Requirements Standard
K0325 Alcohol Based Hand Rub Dispenser (ABHR) Standard
K0351 Sprinkler System - Installation Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0372 Subdivision of Building Spaces ? Smoke Barrier Construction Standard
K0741 Smoking Regulations Standard
▼ 23C0001071 Pain Treatment Centers Of Michigan, Llc 4450 Fashion Square Boulevard, Suite 200 Saginaw MI 5 (Chicago) 06/18/2025 6663B-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0100 ENVIRONMENT Condition
Q0104 SAFETY FROM FIRE Standard
▼ 23C0001071 Pain Treatment Centers Of Michigan, Llc 4450 Fashion Square Boulevard, Suite 200 Saginaw MI 5 (Chicago) 06/16/2025 6663B-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
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 23C0001071 Pain Treatment Centers Of Michigan, Llc 4450 Fashion Square Boulevard, Suite 200 Saginaw MI 5 (Chicago) 06/02/2021 NRC811 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0104 SAFETY FROM FIRE Standard
Q0241 SANITARY ENVIRONMENT Standard
▼ 23C0001071 Pain Treatment Centers Of Michigan, Llc 4450 Fashion Square Boulevard, Suite 200 Saginaw MI 5 (Chicago) 06/02/2021 NRC821 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
K0200 Means of Egress Requirements - Other Standard
K0211 Means of Egress - General Standard
▼ 23C0001072 Surgery Center At Health Park Llp 600 Health Park Blvd, Suite A Grand Blanc MI 5 (Chicago) 08/31/2021 S9VJ11 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0241 SANITARY ENVIRONMENT Standard
▼ 23C0001072 Surgery Center At Health Park Llp 600 Health Park Blvd, Suite A Grand Blanc MI 5 (Chicago) 08/31/2021 S9VJ21 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
K0372 Subdivision of Building Spaces ? Smoke Barrier Construction Standard