S&C QCOR ASC 2567s
d QCOR:  Quality, Certification and Oversight Reports.
ASCs 2567s
Selection Criteria

Time Interval

Please select the calendar year or years for which you would like data.

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
24C0001079 Center For Pain Management Ambulatory Surgery, Ltd. 519 22nd Avenue East Alexandria MN 5 (Chicago) 04/11/2018 CZ5W11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0083 PERFORMANCE IMPROVEMENT PROJECTS Standard
Q0084 GOVERNING BODY RESPONSIBILITIES Standard
Q0104 SAFETY FROM FIRE Standard
Q0267 DISCHARGE WITH RESPONSIBLE ADULT Standard
24C0001079 Center For Pain Management Ambulatory Surgery, Ltd. 519 22nd Avenue East Alexandria MN 5 (Chicago) 04/10/2018 CZ5W21 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0211 Means of Egress - General Standard
K0341 Fire Alarm System - Installation Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0901 Fundamentals - Building System Categories Standard
K0914 Electrical Systems - Maintenance and Testing Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
24C0001080 Minnesota Eye Laser & Surgery Centers, Llc 10709 Wayzata Blvd Suite 100 Minnetonka MN 5 (Chicago) 07/22/2025 66665-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0321 Hazardous Areas - Enclosure Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0712 Fire Drills Standard
K0901 Fundamentals - Building System Categories Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
24C0001080 Minnesota Eye Laser & Surgery Centers, Llc 10709 Wayzata Blvd Suite 100 Minnetonka MN 5 (Chicago) 07/28/2022 4F130-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0240 INFECTION CONTROL Condition
24C0001081 Cdi Twin Cities Asc, Llc 6025 Lake Road Suite 100 Woodbury MN 5 (Chicago) 04/08/2025 659A3-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0000 Initial Comments - Not a Deficiency Citation Memo
E0022 Policies/Procedures for Sheltering in Place Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0026 Roles Under a Waiver Declared by Secretary Standard
Q0221 NOTICE OF RIGHTS Standard
24C0001083 Ridges Surgery Center Llc 14101 Fairview Drive Ste 400 Burnsville MN 5 (Chicago) 06/13/2018 EGGP11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0041 CONTRACT SERVICES Standard
Q0062 ANESTHETIC - DISCHARGE Standard
Q0101 PHYSICIAL ENVIRONMENT Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0262 PRE-SURGICAL ASSESSMENT Standard
Q0266 DISCHARGE - ORDER Standard
Q0267 DISCHARGE WITH RESPONSIBLE ADULT Standard
24C0001086 Woodbury Surgical Suites Llc 587 Bielenberg Drive Ste 100 Woodbury MN 5 (Chicago) 02/09/2021 FHBQ11 Complaint, Focused Infection Control, Other-Fed
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0242 INFECTION CONTROL PROGRAM Standard
24C0001087 Minnesota Endoscopy Center Llc 2635 University Ave W Ste 100 Saint Paul MN 5 (Chicago) 08/10/2018 GZYJ11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0000 Initial Comments - Not a Deficiency Citation Memo
E0007 EP Program Patient Population Standard
E0022 Policies/Procedures for Sheltering in Place Standard
E0037 EP Training Program Standard
Q0224 ADVANCED DIRECTIVES Standard
24C0001088 Minnetonka Ambulatory Surgery 15450 Highway 7 Suite 200 Minnetonka MN 5 (Chicago) 06/05/2019 7P9311 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0000 Initial Comments - Not a Deficiency Citation Memo
E0026 Roles Under a Waiver Declared by Secretary Standard
E0032 Primary/Alternate Means for Communication Standard
E0037 EP Training Program Standard
24C0001092 Twin Cities Surgery Center 7211 Ohms Lane Edina MN 5 (Chicago) 03/04/2020 Q8BU11 Recertification, Sample Validation
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
Q0104 SAFETY FROM FIRE Standard
Q0162 FORM AND CONTENT OF RECORD Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0262 ADMISSION AND PRE-SURGICAL ASSESSMENT Standard
Q0267 DISCHARGE WITH RESPONSIBLE ADULT Standard